title: Assessing Nephrological Competence among Geriatricians: A Proof of Concept Internet Survey.
abstract: Chronic kidney disease (CKD) is highly prevalent in the elderly and negatively impacts survival and health status. Thus, nephrological competence is mandatory for a skilled geriatrician. The present study aimed to assess nephrological competence in a sample of geriatricians recruited through a web survey. To this aim, a 12-items questionnaire was produced by an expert panel of nephrologists and geriatricians and was available online for members of the Italian Society of Gerontology and Geriatrics (SIGG). Two-hundred-eighty-seven geriatricians volunteered to fill in the questionnaire. The majority of them indirectly estimated the glomerular filtration rate (GFR) using mainly the Cockroft-Gault (C-G) formula. Selected nephrological exams, such as urinary Na and serum D-vitamin measurements, did not qualify as routine exams although the majority of geriatricians supplemented their patients with fat-soluble secosteroids. Ten percent of geriatricians asked for nephrological consultation only for stage 5 CKD patients and 30,9% only for stage 4 or 5. Erythropoietin supplementation was common practice for the majority of geriatricians, while only one third of them systematically used a procedure intended to prevent the contrast induced nephropathy (CIN). Finally, an alleged 50% adherence to the international guidelines for the management of CKD patients emerged from the questionnaire. Overall, results from this survey strongly recommend promoting nephrological education among geriatricians. Didactic standards for in training geriatricians need to be updated and the cooperation between geriatrics and nephrological societies promoted.
authors.affiliation: Dept of Geriatrics, Campus Bio-Medico University, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli Incalzi
authors.affiliation: Dept of Nephrology and Dialysis, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Foggia, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Aucella
authors.affiliation: Dept of Translational Medical Science, University of Naples Federico II, Napoli, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Leosco
authors.affiliation: Dept of Nephrology and Dialysis, S. Chiara Hospital, Trento, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Brunori
authors.affiliation: Dept. of Health and Social Service, Provincia Autonoma di Trento, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Dalmartello
authors.affiliation: Department of Medical, Surgical, Neurological, Aging and Metabolic Sciences, Second University of Naples, Napoli, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000188:drug therapy / Q000652:urine; D012964:Sodium / Q000652:urine*; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000097:blood*
chemical_list: D004921:Erythropoietin; D014807:Vitamin D; D012964:Sodium