title: Impact of estimated GFR reporting on patients, clinicians, and health-care systems: a systematic review.
abstract: BACKGROUND
  Many laboratories now report estimated glomerular filtration rate (eGFR) when a serum creatinine measurement is ordered. A summary of the impact of eGFR reporting in health care systems around the world for which it has been adopted is lacking.
  
  
  METHODS
  Systematic review of MEDLINE, EMBASE, other major databases, and conference proceedings of major nephrology meetings.
  
  
  METHODS
  Any health care system in which eGFR reporting was introduced.
  
  
  METHODS
  Published studies or abstracts reporting patient, clinician, or health system outcomes of eGFR reporting.
  
  
  METHODS
  eGFR reporting.
  
  
  RESULTS
  Volume of referrals or consults seen by nephrologists, changes in characteristics of patients who were seen, and prescription rates of kidney-related medications.
  
  
  RESULTS
  22 studies (10 full text and 12 conference abstracts) were identified in 2004-2010 from 5 countries. Nephrologist referrals and consultations increased after eGFR reporting, ranging from 13%-270%. The greatest increases in referrals were seen for the elderly, females, and those with stage 3 or higher chronic kidney disease (eGFR <60 mL/min/1.73 m(2)). Change in renin-angiotensin-aldosterone system-blocking drug use ranged from increases of 0%-6%.
  
  
  CONCLUSIONS
  Studies were highly variable in definition of outcomes. Reports were not available for many health care systems in which eGFR reporting was implemented.
  
  
  CONCLUSIONS
  eGFR reporting has been associated with greater identification of patients with decreased kidney function in most health care systems that have reported its impact.
authors.affiliation: Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: Yoan K
authors.initials: YK
authors.lastname: Kagoma
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Weir
authors.forename: Arthur V
authors.initials: AV
authors.lastname: Iansavichus
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.forename: Ayub
authors.initials: A
authors.lastname: Akbari
authors.forename: Uptal D
authors.initials: UD
authors.lastname: Patel
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.forename: Arsh K
authors.initials: AK
authors.lastname: Jain
mesh_terms: D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002908:Chronic Disease; D003695:Delivery of Health Care; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007674:Kidney Diseases / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012189:Retrospective Studies
chemical_list: D018674:Adrenergic Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors