Patterns of kidney function and risk assessment in a nationwide laboratory database: the Brazilian CHECK-CKD study.
BMC Nephrol
; 25(1): 191, 2024 Jun 04.
Article
in En
| MEDLINE
| ID: mdl-38831397
ABSTRACT
BACKGROUND:
Chronic kidney disease (CKD) is a global health problem with rising prevalence, morbidity, mortality, and associated costs. Early identification and risk stratification are key to preventing progression to kidney failure. However, there is a paucity of data on practice patterns of kidney function assessment to guide the development of improvement strategies, particularly in lower-income countries.METHODS:
A retrospective observational analysis was conducted in a nationwide laboratory database in Brazil. We included all adult patients with at least one serum creatinine assessment between June 2018 and May 2021. Our primary objective was to determine the proportion of patients with estimated glomerular filtration rate (eGFR) evaluations accompanied by predicted levels of urinary albumin-to-creatinine ratio (pACR) assessments within 12 months.RESULTS:
Out of 4,5323,332 serum creatinine measurements, 42% lacked pACR measurements within 12 months. Approximately 10.8% of tests suggested CKD, mostly at stage 3a. The proportion of serum creatinine exams paired with pACR assessment varied according to the CKD stage. Internal Medicine, Cardiology, and Obstetrics/Gynecology were the specialties requesting most of the creatinine tests. Nephrology contributed with only 1.1% of serum creatinine requests for testing.CONCLUSION:
Our findings reveal that a significant proportion of individuals with a creatinine test lack an accompanying urinary albuminuria measurement in Brazil, contrary to the recommendations of the international guidelines. Non-Nephrologists perform most kidney function evaluations, even among patients with presumable advanced CKD. This highlights the urge to incorporate in clinical practice the early detection of CKD and to encourage more collaborative multidisciplinary care to improve CKD management.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Creatinine
/
Albuminuria
/
Renal Insufficiency, Chronic
/
Glomerular Filtration Rate
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
BMC Nephrol
Journal subject:
NEFROLOGIA
Year:
2024
Type:
Article
Affiliation country:
Brazil