| Identifying chronic kidney disease in an emergency department: a chance for an early diagnosis. | |
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MedLine Citation:
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PMID: 21346694 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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INTRODUCTION: Chronic kidney disease (CKD) has relatively asymptomatic course, but even at its onset, it worsens the prognosis of patients, mainly because of the increased risk of cardiovascular diseases. Several population-based screening programs as well as initiatives focused on certain risk groups were undertaken to better diagnose early stages of CKD. It appears that an emergency department (ED) of a hospital may be the right place to screen for early CKD. OBJECTIVES: The aim of the study was to assess the accuracy of ED practices in the detection of CKD. PATIENTS AND METHODS: The study involved 176 subjects who presented at the ED over 1 month and were subsequently admitted to one of the wards at the general hospital. Blood pressure on admission was recorded in 61% of the patients; serum creatinine and estimated glomerular filtration rate (eGFR) were measured in 50% of the subjects, urea in 42.2%, potassium in 87.5%, and glucose in 82%. Patients with previously diagnosed CKD were excluded from the study. RESULTS: Sixty-three per cent of blood pressure values exceeded 140/90 mmHg, 27.3% of all creatinine samples exceeded the upper limit of 1.2 mg/dl, and 64.8% of eGFR results were below 90 ml/min/1.73 m2 (mean 78 ±36 ml/min/1.73 m2). Abnormal levels of urea (>50 mg/dl) were observed in 32% of the patients. Potassium levels were within the reference range in 81.5% of the patients (3.5-5.0 mmol/l; only 10.4% exceeding 5 mmol/l). Elevated glucose levels (>110 mg/dl) were observed in 60% of the patients. CONCLUSIONS: ED practices could be used to identify a significant number of patients with undiagnosed CKD. However, these simple, widely available, and cost-effective methods of early CKD detection are underused. Our results show that there is an urgent need for a structural screening program for CKD at the level of ED. |
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Authors:
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Krystyna Rohun; Marzena Kuliś; Anna Pawłowska; Irena Kierzkowska; Norbert Kwella; Bogna Kwella; Agnieszka Iłowska-Bierawska; Maria Napora; Alicja Całka; Dorota Wiatr-Bykowska; Elżbieta Bandurska-Stankiewicz; Tomasz Stompór |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Polskie Archiwum Medycyny Wewnętrznej Volume: 121 ISSN: 1897-9483 ISO Abbreviation: Pol. Arch. Med. Wewn. Publication Date: 2011 Jan-Feb |
Date Detail:
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Created Date: 2011-02-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401225 Medline TA: Pol Arch Med Wewn Country: Poland |
Other Details:
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Languages: eng Pagination: 23-8 Citation Subset: IM |
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