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Chronic kidney disease care delivered by US family medicine and internal medicine trainees: results from an online survey.

Lenz O, Fornoni A - BMC Med (2006)

Bottom Line: Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD.Our data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees.Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.

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Affiliation: Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, USA. olenz@med.miami.edu

ABSTRACT

Background: Complications of chronic kidney disease (CKD) contribute to morbidity and mortality. Consequently, treatment guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatment goals in order to initiate timely therapy and referral.

Methods: We performed a web-based survey to assess perceptions and practice patterns in CKD care among 376 family medicine and internal medicine trainees in the United States. Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD.

Results: Our data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees.

Conclusion: Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.

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Related in: MedlinePlus

Evaluating kidney function. Shown is the proportion of respondents who identified serum creatinine, measured creatinine clearance, or estimated glomerular filtration rate (GFR), respectively, as the best method to evaluate kidney function. **p < 0.005; ***p < 0.0005 (family medicine versus internal medicine trainees).
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Figure 2: Evaluating kidney function. Shown is the proportion of respondents who identified serum creatinine, measured creatinine clearance, or estimated glomerular filtration rate (GFR), respectively, as the best method to evaluate kidney function. **p < 0.005; ***p < 0.0005 (family medicine versus internal medicine trainees).

Mentions: Participants were asked to identify the best method to estimated kidney function (Figure 2). Timed urine collection for creatinine was the most common choice, followed by estimated glomerular filtration rate (eGFR) using a mathematical formula. Compared to family medicine residents, a significantly higher proportion of internal medicine trainees, but not attending physicians, preferred eGFR over measured creatinine clearance (p < 0.0001).


Chronic kidney disease care delivered by US family medicine and internal medicine trainees: results from an online survey.

Lenz O, Fornoni A - BMC Med (2006)

Evaluating kidney function. Shown is the proportion of respondents who identified serum creatinine, measured creatinine clearance, or estimated glomerular filtration rate (GFR), respectively, as the best method to evaluate kidney function. **p < 0.005; ***p < 0.0005 (family medicine versus internal medicine trainees).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1713248&req=5

Figure 2: Evaluating kidney function. Shown is the proportion of respondents who identified serum creatinine, measured creatinine clearance, or estimated glomerular filtration rate (GFR), respectively, as the best method to evaluate kidney function. **p < 0.005; ***p < 0.0005 (family medicine versus internal medicine trainees).
Mentions: Participants were asked to identify the best method to estimated kidney function (Figure 2). Timed urine collection for creatinine was the most common choice, followed by estimated glomerular filtration rate (eGFR) using a mathematical formula. Compared to family medicine residents, a significantly higher proportion of internal medicine trainees, but not attending physicians, preferred eGFR over measured creatinine clearance (p < 0.0001).

Bottom Line: Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD.Our data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees.Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, USA. olenz@med.miami.edu

ABSTRACT

Background: Complications of chronic kidney disease (CKD) contribute to morbidity and mortality. Consequently, treatment guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatment goals in order to initiate timely therapy and referral.

Methods: We performed a web-based survey to assess perceptions and practice patterns in CKD care among 376 family medicine and internal medicine trainees in the United States. Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD.

Results: Our data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees.

Conclusion: Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.

Show MeSH
Related in: MedlinePlus