Document Detail

Identifying chronic kidney disease in an emergency department: a chance for an early diagnosis.
MedLine Citation:
PMID:  21346694     Owner:  NLM     Status:  In-Data-Review    
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.
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:
Type:  Journal Article    
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewnętrznej     Volume:  121     ISSN:  1897-9483     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-02-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  23-8     Citation Subset:  IM    
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