Renal anaemia in primary care


Project title: Testing a new stepwise strategy for the management of renal anaemia in primary care – an exploratory cluster randomised trial


Anaemia is common in people with chronic kidney disease (CKD), and is associated with poor health outcomes. In the United Kingdom, CKD is largely managed in primary care, and although anaemia is a cardiovascular risk factor, few people with anaemia and CKD currently have active management of their anaemia. Many trials have studied anaemia management in CKD, but these have been conducted in specialist renal units, a trial is needed of other interventions to where can i buy metronidazole online manage anaemia in primary care.


This study aims to develop and evaluate a step-wise model of intervention for treating anaemia in people with CKD in primary care.

Subjects and Setting

The research team will recruit 20 GP practices in London and Southeast England. Patients with CKD and anaemia, who are not under the care of a renal physician are the subject of this study.


The study adopts the Medical Research Council’s framework for the development and evaluation of viagra dose complex interventions in health care services. It has two distinct phases:

Phase 1: Diagnostic analysis and define the step-wise intervention (Year 1)

Using qualitative research methods, the study will explore the buy advair diskus reasons for any variation from NICE guidance and whether the proposed step-wise intervention is both feasible and discount cialis cannada advised to acceptable.

Phase 2: Cluster randomised trial (Years 2 and 3)

Conduct a two-arm randomised study to evaluate the effectiveness of step-wise intervention:

  1. Step-wise intervention
  2. Usual practice

Outcome measures

Primary outcome measures:

  • Proportion of people with CKD who remain anaemic one year after the study
  • comparing change in haemoglobin levels and % of patients with Hb