| アブストラクト | BACKGROUND: Stage 3 chronic kidney disease (CKD) often remains undiagnosed until more severe symptoms appear. This study assessed awareness and management of CKD among Italian general practitioners (GPs), focusing on early detection and current practices. METHODS: A nation-wide, retrospective observational study was conducted using data from The Health Improvement Network (THIN(R)) database. Each participant was required to have had at least one interaction with a GP for either medical or administrative purposes (considering the index date), and to have a minimum of three years of retrospective data available from January 2021 to June 2022. The study evaluated the proportion of individuals aged >/= 40 years who underwent a second serum creatinine test after >/= 90 days, referrals to nephrologists, and CKD diagnosis confirmation and categorization. Multivariable Poisson regression models analyzed data to identify associations between patient characteristics and outcomes, in both the overall cohort and in the sub-group with available urine albumin-to-creatinine ratio (uACR) measurement. RESULTS: Among 347,548 adults aged >/= 40 years, 18,002 (5.2%) had an initial estimated glomerular filtration rate (eGFR) indicating possible stage 3 CKD (30-59 mL/min/1.73 m(2)), and 1495 of these had a concomitant uACR assessment. Data concerning follow-up testing and specialist referrals were inconsistent, and available only for 53.0% and 9.0% of the patients, respectively. Overall, 15.3% met the criteria for KDIGO stage 3 CKD, yet CKD ICD-9-CM diagnostic codes were recorded for only 905 (5.0%) patients. Factors associated with these outcomes were analyzed, including age, comorbidities, treatments, and laboratory values. CONCLUSIONS: Substantial gaps in GP awareness and adherence to CKD management guidelines were identified, particularly in follow-up testing, referral practices, and diagnostic coding. Targeted educational interventions and standardized care protocols are needed to enhance CKD detection and management in primary care, improving patient outcomes and healthcare system performance. |
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| ジャーナル名 | Journal of nephrology |
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| Pubmed追加日 | 2025/8/24 |
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| 投稿者 | Ferrara, Pietro; Rozza, Davide; Antonazzo, Ippazio C; Zamparini, Manuel; Ferrari, Elena Zanzottera; Palladino, Pasquale; Santoro, Domenico; Mantovani, Lorenzo G; Mazzaglia, Giampiero |
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| 組織名 | Center for Public Health Research, University of Milan-Bicocca, Via Cadore 48 -;U38 Building, 20900, Monza, Italy.;Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, Milan, Italy.;U38 Building, 20900, Monza, Italy. d.rozza4@campus.unimib.it.;Cegedim Health Data, Milan, Italy.;Unit of Nephrology and Dialysis, Department of Clinical and Experimental;Medicine, A.O.U. 'G. Martino', University of Messina, Messina, Italy. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40849875/ |
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