PMID: 18184519Jan 11, 2008Paper

Under-recognition of chronic kidney disease in elderly outpatients

Clinical Nephrology
R OusephE D Lederer

Abstract

The elderly are the fastest growing segment of the United States population. Age is a key predictor of chronic kidney disease (CKD). A major obstacle in the recognition of CKD in the elderly is the reliance on serum creatinine measurements as an estimation of glomerular filtration rate (GFR). We hypothesized that early stages of CKD would not be recognized by primary care clinicians providing care to elderly men in a highly structured setting. This study was a retrospective study of outpatients 70 years and older seen in VISN 9 at Veterans Administration Medical Centers from 1/1/2001 thru 12/31/2003. GFR was estimated using the MDRD formula. We abstracted demographic and medical data from the electronic medical record. The population consisted primarily of elderly white male (7,289 men; 91% Caucasian). In CKD Stage 2, 3, and 4, men had a diagnosis code reflecting kidney disease in 1.2%, 20%, and 74.6% of the charts. Despite declining kidney function, nephrology consults were requested in fewer than 5%. In summary, we have shown in a large outpatient population of elderly men that CKD is frequently under-recognized, but most pronounced in CKD Stages 2 and 3. Stages 2 and 3 may be the stages in which the most beneficial effects o...Continue Reading

Citations

Oct 23, 2008·Current Opinion in Nephrology and Hypertension·Danilo Fliser
Oct 5, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jerzy ChudekAndrzej Wiecek
Dec 22, 2009·Clinical and Experimental Nephrology·Benjamin D MorrowCasey L Cotant
Aug 24, 2011·Renal Failure·Margaret MacDougall-Rivers, Lisa Phillips
May 5, 2010·Advances in Chronic Kidney Disease·Laura C PlantingaNeil R Powe
Feb 5, 2010·Journal of the American Medical Directors Association·William M McClellanJoseph G Ouslander
Jul 12, 2008·Pharmazie in unserer Zeit·Matthias Orth
Nov 21, 2008·Postgraduate Medicine·Ahmed H AbdelhafizMeguid El Nahas
Dec 29, 2020·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Lama GhaziPaul E Drawz
Sep 11, 2021·Renal Failure·Carlos R Franco PalaciosPankaj Goyal

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