Abstract
BackgroundThe National Kidney Foundation has formulated clinical practice guidelines for patients with chronic kidney disease (K/DOQI). However, little is know about how many patients actually achieve these goals in a dedicated clinic for chronic kidney disease.MethodsWe performed a cross-sectional analysis of 198 patients with an estimated glomerular filtration rate of less than 30 ml/min/1.73 m2 and determined whether K/DOQI goals were met for calcium, phosphate, calcium-phosphate product, parathyroid hormone, albumin, bicarbonate, hemoglobin, lipids, and blood pressure.ResultsWe found that only a small number of patients achieved K/DOQI targets. Recent referral to the nephrologist, failure to attend scheduled clinic appointments, African American ethnicity, diabetes, and advanced renal failure were significant predictors of low achievement of K/DOQI goals.ConclusionWe conclude that raising awareness of chronic kidney disease and K/DOQI goals among primary care providers, early referral to a nephrologist, the exploration of socioeconomic barriers and cultural differences, and both patient and physician education are critical to improve CKD care in patients with Stage 4 and 5 CKD.
Highlights
The National Kidney Foundation has formulated clinical practice guidelines for patients with chronic kidney disease (K/DOQI)
The purpose of this cross-sectional analysis is determine to what extent K/DOQI goals are achieved in a dedicated Chronic Kidney Disease (CKD) clinic serving a urban, socio-economically disadvantaged minority population
Median follow-up time for short nephrology care (SNC) patients was 2 months, while the median follow-up for long nephrology care (LNC) patients with nephrology care was 33 months. 44% of LNC patients had been followed for 3 years or more
Summary
The National Kidney Foundation has formulated clinical practice guidelines for patients with chronic kidney disease (K/DOQI). The National Kidney Foundation has recently launched a major effort to define Chronic Kidney Disease (CKD) and formulate clinical practice guidelines [1,2]. It has been proposed that care for patients with CKD be best delivered in dedicated CKD clinics that provide a multidisciplinary approach to patients with CKD [11,12]. Little is known about the effectiveness of these clinics at academic centers The purpose of this cross-sectional analysis is determine to what extent K/DOQI goals are achieved in a dedicated CKD clinic serving a urban, socio-economically disadvantaged minority population
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