CKD risk factors reported by primary care physicians: do guidelines make a difference?
BACKGROUND
End-stage renal disease is epidemic within the United States among certain high-risk groups. The National Kidney Disease Education Program examined the awareness of chronic kidney disease (CKD) risk factors among primary care physicians who treat high-risk populations, such as African Americans, persons with diabetes, persons with hypertension, and family members of dialysis patients.


METHODS
We conducted a survey of 465 primary care physicians in 4 communities with high-risk populations. Respondents were asked to score 9 potential CKD risk factors on a 4-point scale graded from "Does not increase risk at all" to "Increases risk greatly." Potential risk factors included African-American race, diabetes, hypertension, and family history of CKD.


RESULTS
Respondents saw a mean of 414 +/- 222 (SD) patients/mo. Primary care physicians were more likely to report that diabetes and hypertension were significant risk factors for CKD. Conversely, 34.4% did not consider family history of kidney disease to increase the risk for CKD, and 22% of respondents did not consider African-American race a CKD risk factor.


CONCLUSIONS
Primary care physicians need targeted education to increase awareness of populations at high risk for CKD.
Lea
Janice P
JP
Renal Division, Department of Medicine, Rollins School of Public Health, Emory University, Atlanta, GA, USA. jlea@emory.edu
McClellan
William M
WM
Melcher
Charlene
C
Gladstone
Elisa
E
Hostetter
Tom
T
D015142:Baltimore / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data*; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology; D004198:Disease Susceptibility; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007388:Internal Medicine / Q000706:statistics & numerical data; D007674:Kidney Diseases / Q000453:epidemiology* / Q000208:ethnology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D008297:Male; D008922:Mississippi / Q000453:epidemiology; D009820:Ohio / Q000453:epidemiology; D010821:Physicians, Family / Q000523:psychology*; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D006435:Renal Dialysis; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American