TY - JOUR
T1 - Barriers to successful care for chronic kidney disease
AU - Lenz, Oliver
AU - Mekala, Durga P.
AU - Patel, Daniel V.
AU - Fornoni, Alessia
AU - Metz, David
AU - Roth, David
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2005/10/27
Y1 - 2005/10/27
N2 - Background: The 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. Methods: We 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. Results: We 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. Conclusion: We 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.
AB - Background: The 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. Methods: We 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. Results: We 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. Conclusion: We 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.
UR - http://www.scopus.com/inward/record.url?scp=27844597274&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27844597274&partnerID=8YFLogxK
U2 - 10.1186/1471-2369-6-11
DO - 10.1186/1471-2369-6-11
M3 - Article
C2 - 16250919
AN - SCOPUS:27844597274
VL - 6
JO - BMC Nephrology
JF - BMC Nephrology
SN - 1471-2369
M1 - 11
ER -