Patient not told his kidneys were failing

A doctor has been admonished after failing for five years to properly inform a man that his kidney function was deteriorating.

The man now has stage 4 kidney failure and may need a transplant. Deputy Health and Disability Commissioner Morag Mcdowell has found the general practice doctor in breach of the patients’ rights code for ‘‘deficiencies’’ in the patient’s care and recommended the Medical Council consider whether a review of his competence is warranted.

The patient, in his 30s, saw the GP in July 2015, Mcdowell’s report, released yesterday, said.

The patient requested Brufen (a non-steroidal anti-inflammatory, or NSAID) for chronic back pain.

Tests showed impaired renal (kidney) function, which Dr B thought was linked to the patient’s use of NSAIDS – but there was no evidence the patient was given the abnormal result. Kidneys cleanse blood of toxins and transform waste into urine. NSAIDS can lead to decreased blood flow to the kidneys, which can injure them.

The report said the July 2015 test indicated the patient had chronic kidney disease but the GP ‘‘failed to understand the real or potential severity’’ then or in subsequent consultations. Results from a June 2016 test showed the patient’s kidney function was ‘‘chronically impaired but stable’’.

However, there was no documented discussion of these results with the patient. There was also no discussion about the risk of continuous NSAID use – which the GP was still prescribing.

A February 2017 test showed further deterioration but it was not until July that the doctor documented they ‘‘discussed renal function’’. The patient told the Health and Disability Commission he recalled a conversation with his GP about his kidney dysfunction, in which the GP said he ‘‘had the kidneys of a 60-year-old’’ and that the situation would be monitored. However, he was not alerted to the significance of the test results.

The GP requested renal function tests eight times between July 2015 to October 2019. Five were completed. In November 2019, the patient was diagnosed with stage 4 kidney disease at an emergency department. This means advanced kidney damage and dialysis or a kidney transplant is likely in the future. The patient’s wife said ‘‘if we found out five years ago ... we could have made lifestyle changes to slow the progression of the disease ... we could have appreciated life and our young family ... while [my husband] was well enough to do so.’’