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Titolo:
Management of patients with chronic renal insufficiency in the northeastern United States
Autore:
Kausz, AT; Khan, SS; Abichandani, R; Kazmi, WH; Obrador, GT; Ruthazer, R; Pereira, BJG;
Indirizzi:
New England Med Ctr, Dept Med, Div Nephrol, Boston, MA 02111 USA New England Med Ctr Boston MA USA 02111 Div Nephrol, Boston, MA 02111 USA New England Med Ctr, Dept Med, Div Clin Care Res, Boston, MA 02111 USA NewEngland Med Ctr Boston MA USA 02111 in Care Res, Boston, MA 02111 USA
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
fascicolo: 7, volume: 12, anno: 2001,
pagine: 1501 - 1507
SICI:
1046-6673(200107)12:7<1501:MOPWCR>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONVERTING ENZYME-INHIBITION; BLOOD-PRESSURE CONTROL; HEMODIALYSIS-PATIENTS; DIABETIC NEPHROPATHY; DIALYSIS PATIENTS; SERUM CREATININE; DISEASE; PROGRESSION; MORTALITY; FAILURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Kausz, AT New England Med Ctr, Dept Med, Div Nephrol, Box 391, Boston, MA 02111 USA New England Med Ctr Box 391 Boston MA USA 02111 on, MA 02111 USA
Citazione:
A.T. Kausz et al., "Management of patients with chronic renal insufficiency in the northeastern United States", J AM S NEPH, 12(7), 2001, pp. 1501-1507

Abstract

Comorbid conditions that develop during chronic renal insufficiency (CRI) contribute to the high morbidity and mortality among patients with end-stage renal disease (ESRD). Thus, appropriate management during CRI may lead toimproved ESRD outcomes. A retrospective cohort study was performed to describe the management of patients with CRI. A total of 602 patients with CRI (creatinine greater than or equal to1.5 mg/dl for women and greater than orequal to2.0 mg/dl for men) were seen between October 1994 and September 1998 at five nephrology outpatient clinics in the Boston area. The mean (SD) age of the patients was 63 (15.5) yr, and 53% were male. At the first nephrology visit, mean (SD) serum creatinine was 3.2 (1.6) mg/dl, and mean (SD) predicted GFR was 22.3 (8.9) ml/min per 1.73 m(2). Laboratory tests for iron levels were performed in only 18% of patients, serum parathyroid hormone levels were obtained in only 15%, lipid studies were obtained in fewer thanhalf, and among patients with diabetes, only 28% had a glycosylated hemoglobin level measured. A hematocrit <30% was present in 38%, and abnormal calcium-phosphorus metabolism was noted in 55%. Only 59% of patients who had hematocrit <30%, received recombinant human erythropoietin. Among patients who received recombinant human erythropoietin, only 47% received iron. Angiotensin-converting enzyme inhibitor use was recorded for only 65% of patients with diabetes (49% of patients overall). Among patients who were known tohave progressed to ESRD, only 41% had permanent access placed before initiation of dialysis. There seems to be room for improvement in the managementof patients with CRI, which could result in a slower rate of progression of CRI and reduced severity of comorbid conditions.

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Documento generato il 06/04/20 alle ore 05:42:45