Chronic kidney disease management in an academic internal medicine clinic.
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).


CONCLUSIONS
Chronic kidney disease remains under-recognized and undertreated despite well-publicized guidelines and widespread use of routine eGFR reporting.
Morrow
Benjamin D
BD
Department of Medicine, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA. Benjamin.morrow@lackland.af.mil
Stewart
Ian J
IJ
Barnes
Eric W
EW
Cotant
Casey L
CL
D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000150:complications; D048909:Diabetes Complications; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000150:complications; D007388:Internal Medicine; D007396:Internship and Residency; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012017:Referral and Consultation; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors