Perspectives on eGFR reporting from the interface between primary and secondary care.

The introduction of estimated GFR (eGFR) reporting based on the Modification of Diet in Renal Disease (MDRD) equation has caused much debate regarding its value in the wider community. In particular, automated reporting of eGFR by laboratories has led to concern that it is being used as a "covert " screening tool, in populations in which the MDRD equation has known inaccuracies. There is a fear of creating a population of "worried well, " with potential impact on patients and implications for the use of resources. It is established that in certain groups, chronic kidney disease confers a greatly increased risk of cardiovascular disease, yet risk factors remain inadequately managed. We believe that eGFR reporting allows the opportunity to stratify risk and improve outcome among a wide population.