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Journal Article

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Farmer, A.J,. , Stevens, R, Hirst J., Lung T., Oke, J., Clarke, P., Neil, A., Glasziou, P., Dunger, D., Colhourn, H., Pugh, C., Wong, G., Perera, R., & Shine, B. (2014). Optimal strategies for identifying kidney disease in diabetes: properties of screening tests, progression of renal dysfunction and impact of treatment – systematic review and modelling of progression and cost-effectiveness. Health Technol Assessment, 18(14).

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© Copyright, Queen's Printer and Controller of HMSO, 2014

2014 HERDC Submission




These results support current UK guidance, which recommends annual screening with ACR to identify early kidney disease in patients with diabetes, despite a high false-positive rate leading to, at worst, unnecessary or, at best, early therapeutic intervention. For type 1 diabetes, screening costs for annual compared with 2-yearly screening are well within the bounds of accepted cost-effectiveness. Annual screening is even more cost-effective in type 2 diabetes than in type 1 diabetes. Identification of alternative markers for developing diabetic nephropathy may improve targeting of treatment for those at high risk.



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