Report Date


Case Against

Cardiff and Vale University Health Board


Clinical treatment in hospital

Case Reference Number



Not Upheld

Mr A complained about the care provided to him by the Health Board relating to his kidney condition. Specifically, the Ombudsman investigated whether:

  • The result of an Albumin to Creatinine Ratio “ACR” test (a test to help identify kidney disease) in April 2017 (21.7mg/mmol) should have prompted an increase in Mr A’s enalapril medication.
  • There should have been repeat yearly ACR tests in 2018 and 2019.

The Ombudsman did not uphold the complaints. The investigation found that maintaining the same dose of enalapril medication following Mr A’s ACR test result in 2017 was reasonable, took account of other clinical factors and was not outside the range of normal clinical practice. In relation to repeating yearly ACR tests in 2018 and 2019, it was appropriate to monitor urine protein levels using a different (PCR) test. This was in line with accepted practice and did not result in any detriment to Mr A.