Awareness of chronic kidney disease in Austria: a frequently under-recognized clinical picture

Wien Klin Wochenschr. 2013 Jul;125(13-14):362-7. doi: 10.1007/s00508-013-0374-7. Epub 2013 Jun 15.

Abstract

Background: The prevalence of chronic kidney disease (CKD) is rising at an alarming rate, thus presenting a substantial burden for the patient as an individual and-because of the enormous treatment costs-for society as a whole. Early diagnosis and therapy could slow disease progression and reduce the prevalence of cost-intensive end stage renal disease. The aim of this study was to determine the accuracy of diagnosis of CKD in acute patients presenting at an internal ward.

Methods: Routine laboratory parameters of kidney function of 238 inpatients were retrospectively evaluated to determine the prevalence of CKD, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2). Those results were compared with the actual documentation of the ICD-10 diagnosis CKD in the discharge reports of the respective patients.

Results: Of 238 patients, 228 patients were included in the analysis. The overall median (range) eGFR was 60.7 (10.4-171.9) mL/min/1.73 m(2), with no gender-specific difference. Of patients, 49.6 % (n = 113) were retrospectively diagnosed with CKD stage 3 or higher. However, the review of the discharge reports found correct diagnosis of CKD in only 38.1 % (n = 43) of these patients.

Conclusions: The present analysis shows that CKD remains frequently unrecognized, even in a hospital setting. This could have dramatic implications on the care, treatment and prevention of CKD and associated complications.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Austria / epidemiology
  • Diagnostic Errors / prevention & control*
  • Diagnostic Errors / statistics & numerical data*
  • Early Diagnosis
  • Female
  • Health Knowledge, Attitudes, Practice
  • Hospitalization / statistics & numerical data*
  • Humans
  • Kidney Function Tests / statistics & numerical data*
  • Male
  • Middle Aged
  • Patient Discharge Summaries / statistics & numerical data*
  • Prevalence
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / epidemiology*
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Sex Distribution
  • Young Adult