title: Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study.
abstract: BACKGROUND
  Chronic Kidney Disease (CKD) is a relatively common condition not only associated with increased morbidity and mortality but also fuelling End Stage Renal Disease (ESRD). Among developed nations, Greece has one of the highest ESRD incidence rates, yet there is limited understanding of the epidemiology of earlier stages of CKD.
  
  
  METHODS
  Cross-sectional survey of pre-dialysis CKD outpatients in nephrology clinics in the National Health Care system between October 2009 and October 2010. Demographics, cause of CKD, blood pressure, level of renal function, duration of CKD and nephrology care, and specialty of referral physician were collected and analyzed. Different methods for estimating renal function (Cockroft-Gault [CG], CKD-Epi and MDRD) and staging CKD were assessed for agreement.
  
  
  RESULTS
  A total of 1,501 patients in 9 centers were enrolled. Diabetic nephropathy was the most common nephrologist assigned cause of CKD (29.7%). In total, 36.5% of patients had self-referred to the nephrologist; patients with diabetes or serum creatinine above 220 µmol/l (eGFR<40 ml/min/1.73 m2) were more likely to have been referred by a physician. Agreement between MDRD and CKD-Epi, but not between CG, the other estimating equations, was excellent. There was substantial heterogeneity with respect to renal diagnoses, referral patterns and blood pressure among participating centers.
  
  
  CONCLUSIONS
  In this first epidemiologic assessment of CKD in Greece, we documented delayed referral and high rates of self-referral among patients with CKD. eGFR reporting, currently offered by a limited number of laboratories, may facilitate detection of CKD at an earlier, more treatable stage.
authors.affiliation: Nephrology Clinic, Papanikolaou Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Sombolos
authors.affiliation: Nephrology Clinic, Papageorgiou Hospital, Thessaloniki, Greece.
authors.forename: Demitrios
authors.initials: D
authors.lastname: Tsakiris
authors.affiliation: Nephrology Clinic, Laiko Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Boletis
authors.affiliation: Nephrology Clinic, ATTIKON University Hospital, Athens, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Vlahakos
authors.affiliation: Nephrology Clinic, Ioannina University Hospital, Ioannina, Greece.
authors.forename: Kostas C
authors.initials: KC
authors.lastname: Siamopoulos
authors.affiliation: Nephrology Clinic, Alexandroupoli University Hospital, Alexandroupoli, Greece.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Vargemezis
authors.affiliation: Nephrology Clinic, AHEPA Hospital, Thessaloniki, Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Nikolaidis
authors.affiliation: Center for Nephrology, G Papadakis, Nikea Hospital, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Iatrou
authors.affiliation: Nephrology Clinic, PE.PA.G.N.I, Crete University Hospital, Iraklio, Greece.
authors.forename: Eugene
authors.initials: E
authors.lastname: Dafnis
authors.affiliation: AbbVie Pharmaceuticals, Chicago, Illinois, United States of America.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Xynos
authors.affiliation: AbbVie Pharmaceuticals SA, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Argyropoulos
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003928:Diabetic Nephropathies / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology*; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D003404:Creatinine