| Physician utilization, risk-factor control, and CKD progression among participants in the Kidney Early Evaluation Program (KEEP). | |
| | |
MedLine Citation:
|
PMID: 22339899 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Chronic kidney disease (CKD) is a well-known risk factor for cardiovascular mortality, but little is known about the association between physician utilization and cardiovascular disease risk-factor control in patients with CKD. We used 2005-2010 data from the National Kidney Foundation's Kidney Early Evaluation Program (KEEP) to examine this association at first and subsequent screenings. METHODS: Control of risk factors was defined as control of blood pressure, glycemia, and cholesterol levels. We used multinomial logistic regression to examine the association between participant characteristics and seeing a nephrologist after adjusting for kidney function and paired t tests or McNemar tests to compare characteristics at first and second screenings. RESULTS: Of 90,009 participants, 61.3% had a primary care physician only, 2.9% had seen a nephrologist, and 15.3% had seen another specialist. The presence of 3 risk factors (hypertension, diabetes, and hypercholesterolemia) increased from 26.8% in participants with CKD stages 1-2 to 31.9% in those with stages 4-5. Target levels of all risk factors were achieved in 7.2% of participants without a physician, 8.3% of those with a primary care physician only, 9.9% of those with a nephrologist, and 10.3% of those with another specialist. Of up to 7,025 participants who met at least one criterion for nephrology consultation at first screening, only 12.3% reported seeing a nephrologist. Insurance coverage was associated strongly with seeing a nephrologist. Of participants who met criteria for nephrology consultation, 406 (5.8%) returned for a second screening, of whom 19.7% saw a nephrologist. The percentage of participants with all risk factors controlled was higher at the second screening (20.9% vs 13.3%). CONCLUSION: Control of cardiovascular risk factors is poor in the KEEP population. The percentage of participants seeing a nephrologist is low, although better after the first screening. Identifying communication barriers between nephrologists and primary care physicians may be a new focus for KEEP. |
| | |
Authors:
|
Claudine T Jurkovitz; Daniel Elliott; Suying Li; Georges Saab; Andrew S Bomback; Keith C Norris; Shu-Cheng Chen; Peter A McCullough; Adam T Whaley-Connell; |
Related Documents
:
|
18020909 - Evaluating the role of biomarkers for cardiovascular risk prediction: focus on crp, bnp... 22383459 - Does passive smoking have an effect on nasal mucociliary clearance? 18541269 - Cerebral small vessel disease and chronic kidney disease (ckd): results of a cross-sect... 18349749 - Hyperuricemia, gout and the metabolic syndrome. 22914589 - Risk of death among persons with alzheimer's disease: a national register-based nested ... 19153409 - Cardiovascular disease risk prediction with and without knowledge of genetic variation ... 18922999 - Seven lipoprotein lipase gene polymorphisms, lipid fractions, and coronary disease: a h... 21987749 - Risk factors for zaire ebolavirus-specific igg in rural gabonese populations. 21987449 - Distribution of human papillomavirus among women with abnormal cervical cytology in kuw... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 59 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2012 Mar |
Date Detail:
|
Created Date: 2012-02-20 Completed Date: 2012-04-23 Revised Date: 2013-05-17 |
Medline Journal Info:
|
Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: United States |
Other Details:
|
Languages: eng Pagination: S24-33 Citation Subset: IM |
Copyright Information:
|
Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Christiana Care Health System, Center for Outcomes Research, Newark, DE 19713, USA. cjurkovitz@christianacare.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Disease Progression Female Health Promotion* Humans Kidney Diseases / diagnosis*, prevention & control* Male Middle Aged Nephrology* Patient Acceptance of Health Care / statistics & numerical data* Referral and Consultation / statistics & numerical data Risk Factors United States |
| Grant Support | |
ID/Acronym/Agency:
|
MD000182/MD/NIMHD NIH HHS; P20 MD000182/MD/NIMHD NIH HHS; P30 AG021684/AG/NIA NIH HHS; R03 AG040638/AG/NIA NIH HHS; R03AG040638-01/AG/NIA NIH HHS; RR026138/RR/NCRR NIH HHS; U54 MD007598/MD/NIMHD NIH HHS; UL1 TR000124/TR/NCATS NIH HHS |
| Investigator | |
Investigator/Affiliation:
|
Peter A McCullough / ; Adam T Whaley-Connell / ; Andrew Bomback / ; Kerri Cavanaugh / ; Linda Fried / ; Claudine Jurkovitz / ; Mikhail Kosiborod / ; Samy McFarlane / ; Rajnish Mehrotr / ; Keith Norris / ; Rulan Savita Parekh / ; Carmen A Peralta / ; Georges Saab / ; Stephen Seliger / ; Michael Shlipak / ; Lesley Inker / ; Manjula Kurella Tamura / ; John Wang / ; Bryan Becker / ; Allan Collins / ; Nilka Ríos Burrows / ; Lynda A Szczech / ; Joseph Vassalott / ; George Bakris / ; Wendy Brown / ; Shu-Cheng Chen / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Associations between access to care and awareness of CKD.
Next Document: Association of physician care with mortality in Kidney Early Evaluation Program (KEEP) participants.