Longer duration of predialysis nephrological care is associated with improved long‐term survival of dialysis patients

Jungers, Paul; Massy, Ziad A.; Nguyen–Khoa, Thao; Choukroun, Gabriel; Robino, Christophe; Fakhouri, Fádi; Touam, Malik; Nguyen, Anh‐Thu; Grünfeld, Jean‐Pierre

doi:10.1093/ndt/16.12.2357

Cited by 156 publications

(140 citation statements)

References 21 publications

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“…We believe this trend is not due to a lack of nephrologists (19). Lack of awareness on the part of patients, their family members, and their physicians (including general practitioners, cardiologists, and diabetologists) about the benefits of regular nephrological care may explain this trend (21). Most members OR, odds ratio; CI, confidence interval; SBP, systolic blood pressure; DBP, diastolic blood pressure; SCr, serum creatinine; BMI, body mass index.…”

Section: Discussionmentioning

confidence: 99%

The Okinawa Screening Program

Iseki¹

2003

Journal of the American Society of Nephrology

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Abstract. Predictors of ESRD were identified using independent registries of both ESRD patients and the general population in Okinawa, Japan. Besides male gender, we found that the significant predictors of ESRD to be proteinuria, hematuria, and hypertension, especially diastolic BP. Among the laboratory findings, a high serum creatinine level was shown to be a strong predictor of ESRD. The effects of age, obesity, and hypercholesterolemia were insignificant, but this needs to be confirmed in a larger cohort and other registries.The number of ESRD patients requiring chronic dialysis is increasing worldwide. In Japan, a high incidence and prevalence of ESRD has been reported in Okinawa, the island prefecture in the southernmost part of the country (1,2). Since 1971, all chronic dialysis patients treated in Okinawa from the start of therapy have been entered into a registry, and the ESRD trends over the past 30 yr have recently been published (1). For geographic and cultural reasons, ESRD patients in Okinawa tend not to move away (3,4). Therefore, Okinawa provides a good population in which to study the outcomes of ESRD and cardiovascular disease (3,4). Understanding the process of disease progression is necessary in determining strategies for the prevention of ESRD.We are fortunate to have access to independent registries for ESRD patients (5), the general population (6,7), and all hospital-based records of stroke and acute myocardial infarction (AMI) (3) in Okinawa. In this paper, we have identified predictors for ESRD using these registries. Materials and Methods Study DesignData from three independent registries covering the entire area of Okinawa were accessed: the ESRD program (5), the screening program of the Okinawa General Health Maintenance Association (OGHMA) (6 -11), and the hospital-based registry of stroke and AMI (3). The start date of chronic dialysis was used as the date of onset of ESRD in individual patients. The 1983 screening participants and the individuals who had become dialysis patients from April 1983 to March 1994 were identified by using the dialysis registry, which covers the entire geographic area. The identities of these dialysis patients were verified by reviewing their medical charts in the dialysis units. ESRD Patient RegistryAll chronic dialysis patients who survive at least 1 mo on scheduled dialysis are included in the Okinawa Dialysis Study (OKIDS) registry.Patients dying within 1 mo from the start of dialysis are not included in the registry because it cannot be determined whether renal function in these patients has been improving or deteriorating or whether other medical conditions accounted for their rapid demise. Pertinent clinical data were obtained for all new dialysis patients, and important medical events recorded in the files of chronic dialysis patients were noted. Data were obtained under collaboration with physicians in all dialysis units. In 1990, there were 27 dialysis units in Okinawa; by the end of 2000, there were 46: nine in the public sector, 17 in private ...

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Section: Discussionmentioning

confidence: 99%

The Okinawa Screening Program

Iseki¹

2003

Journal of the American Society of Nephrology

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“…Seven studies 56,111,[119][120][121][122][123] met the inclusion and exclusion criteria, and were included in the review; their characteristics are summarised in Table 10. We did not find any randomised or controlled trials.…”

Section: Study Characteristicsmentioning

confidence: 99%

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Black

Sharma²,

Scotland³

et al. 2010

Health Technol Assess

174

144

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects...

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“…Awareness of CKD remains unacceptably low, despite recent attempts to increase awareness through dissemination of clinical practice guidelines and recommendations for patients with CKD or its risk factors to providers [20][21][22], including community awareness events such as World Kidney Day [23,24]. Earlier recognition of CKD can slow the progression of CKD, prevent complications, and reduce cardiovascular-related outcomes; additionally, early referral to a nephrologist has been shown to improve outcomes for those who progress to end-stage renal disease [27][28][29][30]. It has been observed that physicians other than nephrologists are less …”

Section: Introductionmentioning

confidence: 99%

Doctors’ knowledge and practices regarding chronic kidney disease at a tertiary care hospital

et al. 2016

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Background: The complications of chronic kidney disease (CKD) significantly contribute to morbidity and mortality, therefore clinical practice guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatments goals in order to initiate timely therapy and referral.Methods: This was a cross-sectional study conducted at three campuses of the Ziauddin University Hospital, Karachi, Pakistan in 2016. A questionnaire based survey was conducted to assess the knowledge and practices of doctors from various specialties regarding CKD.Results: We performed a questionnaire based survey to assess knowledge and practice patterns in CKD care among 156 doctors. There were 63 male and 50 female respondents. There were 24 attending doctors, 73 post-graduate trainees and 25 house-officers. Our data showed that although CKD risk factors are generally recognized, there is a paucity of knowledge regarding CKD management guidelines and staging of CKD. There is an awareness regarding timely referral to nephrology, but many would still not refer at the appropriate stage. Many also do not use standard equations to calculate Glomerular Filtration rate (GFR) and Creatinine Clearance]. Most do screen for diabetic nephropathy, know about ACE-I/ARBs and provide dietary counseling to CKD patients. The majority do not read medical journals to keep their knowledge up-to-date. Junior doctors (post-graduate trainees and house-officers) fared better than attending doctors in the knowledge and practice parameters.

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Longer duration of predialysis nephrological care is associated with improved long‐term survival of dialysis patients

Cited by 156 publications

References 21 publications

The Okinawa Screening Program

The Okinawa Screening Program

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Doctors’ knowledge and practices regarding chronic kidney disease at a tertiary care hospital

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