Original InvestigationPathogenesis and Treatment of Kidney DiseaseReporting of Estimated GFR in the Primary Care Clinic
Section snippets
Study Population
We performed a retrospective review of all outpatients with serum creatinine measured at the Bronx Veterans Affairs Medical Center (BVAMC) laboratory from July 1, 2003, to June 30, 2004. For patients with more than 1 serum creatinine measurement during that time, the most recent was used in the analysis. In August 2004, as per the Veterans Affairs Central Office, BVAMC implemented routine reporting of the 4-variable MDRD Study calculation of eGFR with each measured serum creatinine.1, 16
Results
Of 21,285 patients currently enrolled at the BVAMC, 15,156 adult individuals had at least 1 serum creatinine measured from July 1, 2003, to June 30, 2004, before routine reporting of eGFR. One hundred sixty-eight patients were excluded because they were receiving renal replacement therapy, either dialysis or kidney transplantation, leaving 14,988 patients for analysis. Average age was 63.7 years, and 95% of the study population was male. Self-reported race was available for 57% of subjects,
Discussion
In the current study, routine reporting of eGFR alone without educational intervention improved the documentation and recognition of CKD, but had a minimal effect on treatment. Early recognition and treatment of CKD is vital to reduce the development of end-stage renal disease and cardiovascular events. Because serum creatinine level does not accurately reflect level of kidney function, investigators developed such formulas as the Cockcroft-Gault estimation of creatinine clearance and MDRD
Acknowledgment
The authors thank Dr Jaime Uribarri and Dr Jonathon Winston for constructive criticism during preparation of the manuscript.
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Cited by (57)
Practical Approach to Detection and Management of Chronic Kidney Disease for the Primary Care Clinician
2016, American Journal of Medicine
Originally published online as doi:10.1053/j.ajkd.2007.02.258 on March 27, 2007.
Support: None. Potential conflicts of interest: None.
Work was performed at the Bronx Veterans Affairs Medical Center.