title: CKD as an underrecognized threat to patient safety.
abstract: Chronic kidney disease (CKD) is common, but underrecognized, in patients in the health care system, where improving patient safety is a high priority. Poor disease recognition and several other features of CKD make it a high-risk condition for adverse safety events. In this review, we discuss the unique attributes of CKD that make it a high-risk condition for patient safety mishaps. We point out that adverse safety events in this disease have the potential to contribute to disease progression; namely, accelerated loss of kidney function and increased incidence of end-stage renal disease. We also propose a framework in which to consider patient safety in CKD, highlighting the need for disease-specific safety indicators that reflect unsafe practices in the treatment of this disease. Finally, we discuss the hypothesis that increased recognition of CKD will reduce disease-specific safety events and in this way decrease the likelihood of adverse outcomes, including an accelerated rate of kidney function loss and increased incidence of end-stage renal disease.
authors.affiliation: Department of Medicine, University of Maryland School of Pharmacy, Baltimore, MD 21201, USA. jfink@medicine.umaryland.edu
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Fink
authors.forename: Jeanine
authors.initials: J
authors.lastname: Brown
authors.forename: Van Doren
authors.initials: VD
authors.lastname: Hsu
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Seliger
authors.forename: Loreen
authors.initials: L
authors.lastname: Walker
authors.forename: Min
authors.initials: M
authors.lastname: Zhan
mesh_terms: D002908:Chronic Disease; D018450:Disease Progression; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D019300:Medical Errors / Q000009:adverse effects*; D011379:Prognosis; D012307:Risk Factors