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Chronic kidney disease management in an academic internal medicine clinic

Clinical and Experimental Nephrology volume 14, pages 137–143 (2010)Cite this article

Abstract

Objective

We sought to evaluate the current state of chronic kidney disease (CKD) management in our academic internal medicine clinic.

Methods

A retrospective review was carried out involving all patients with laboratory evidence of CKD enrolled in our clinic. We evaluated the rate of CKD recognition as well as compliance with standard guidelines. We further subdivided our results based on physician training level, presence of diabetes, recognition of CKD, age, and race.

Results

Factors that significantly improved recognition and treatment of CKD in our study included presence of diabetes (p < 0.001), black race (p = 0.013), younger age (p = 0.004), and treatment by a resident physician (p = 0.009). Recognition of stage 3 CKD was associated with significant increases in urine protein analysis (p < 0.001) and nephrology consultation (p < 0.001).

Conclusion

Chronic kidney disease remains under-recognized and undertreated despite well-publicized guidelines and widespread use of routine eGFR reporting.

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Acknowledgments

The authors give special thanks to Dr. Anneke C. Bush for her assistance with the statistical portion of this study.

Author information

Affiliations

  1. Department of Medicine, Wilford Hall Medical Center, 2200 Bergquist Dr Ste 1, Lackland AFB, TX, 78236, USA

    Benjamin D. Morrow, Ian J. Stewart, Eric W. Barnes & Casey L. Cotant

Authors
  1. Benjamin D. Morrow
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  2. Ian J. Stewart
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  3. Eric W. Barnes
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  4. Casey L. Cotant
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Corresponding author

Correspondence to Ian J. Stewart.

Additional information

B. D. Morrow and I. J. Stewart contributed equally to this manuscript.

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Morrow, B.D., Stewart, I.J., Barnes, E.W. et al. Chronic kidney disease management in an academic internal medicine clinic. Clin Exp Nephrol 14, 137–143 (2010). https://doi.org/10.1007/s10157-009-0247-6

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  • DOI: https://doi.org/10.1007/s10157-009-0247-6

Keywords

  • Angiotensin-converting enzyme inhibitor
  • Angiotensin receptor blocker
  • Blood pressure control
  • Chronic kidney disease
  • Glomerular filtration rate
  • Internship and residency