Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study
Chronic Kidney Disease (CKD) is a relatively common condition not only associated with increased morbidity and mortality but also fuelling End Stage Renal Disease (ESRD). Among developed nations, Greece has one of the highest ESRD incidence rates, yet there is limited understanding of the epidemiolo...
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| creator | Sombolos, Konstantinos Tsakiris, Demitrios Boletis, John Vlahakos, Demetrios Siamopoulos, Kostas C Vargemezis, Vassilios Nikolaidis, Pavlos Iatrou, Christos Dafnis, Eugene Xynos, Konstantinos Argyropoulos, Christos |
| description | Chronic Kidney Disease (CKD) is a relatively common condition not only associated with increased morbidity and mortality but also fuelling End Stage Renal Disease (ESRD). Among developed nations, Greece has one of the highest ESRD incidence rates, yet there is limited understanding of the epidemiology of earlier stages of CKD.
Cross-sectional survey of pre-dialysis CKD outpatients in nephrology clinics in the National Health Care system between October 2009 and October 2010. Demographics, cause of CKD, blood pressure, level of renal function, duration of CKD and nephrology care, and specialty of referral physician were collected and analyzed. Different methods for estimating renal function (Cockroft-Gault [CG], CKD-Epi and MDRD) and staging CKD were assessed for agreement.
A total of 1,501 patients in 9 centers were enrolled. Diabetic nephropathy was the most common nephrologist assigned cause of CKD (29.7%). In total, 36.5% of patients had self-referred to the nephrologist; patients with diabetes or serum creatinine above 220 µmol/l (eGFR |
| doi_str_mv | 10.1371/journal.pone.0112767 |
| format | Article |
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Cross-sectional survey of pre-dialysis CKD outpatients in nephrology clinics in the National Health Care system between October 2009 and October 2010. Demographics, cause of CKD, blood pressure, level of renal function, duration of CKD and nephrology care, and specialty of referral physician were collected and analyzed. Different methods for estimating renal function (Cockroft-Gault [CG], CKD-Epi and MDRD) and staging CKD were assessed for agreement.
A total of 1,501 patients in 9 centers were enrolled. Diabetic nephropathy was the most common nephrologist assigned cause of CKD (29.7%). In total, 36.5% of patients had self-referred to the nephrologist; patients with diabetes or serum creatinine above 220 µmol/l (eGFR<40 ml/min/1.73 m2) were more likely to have been referred by a physician. Agreement between MDRD and CKD-Epi, but not between CG, the other estimating equations, was excellent. There was substantial heterogeneity with respect to renal diagnoses, referral patterns and blood pressure among participating centers.
In this first epidemiologic assessment of CKD in Greece, we documented delayed referral and high rates of self-referral among patients with CKD. eGFR reporting, currently offered by a limited number of laboratories, may facilitate detection of CKD at an earlier, more treatable stage.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0112767</identifier><identifier>PMID: 25406080</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Biology and Life Sciences ; Blood ; Blood Pressure ; Chronic kidney failure ; Clinics ; Creatinine ; Creatinine - blood ; Cross-Sectional Studies ; Demographics ; Demography ; Developed countries ; Diabetes ; Diabetes mellitus ; Diabetic nephropathies ; Diabetic Nephropathies - complications ; Diabetic Nephropathies - epidemiology ; Diabetic nephropathy ; Dialysis ; Epidemiology ; Epidermal growth factor receptors ; Estimation ; Female ; Greece - epidemiology ; Health aspects ; Health care ; Hemodialysis ; Heterogeneity ; Hospitals ; Humans ; Kidney - physiology ; Kidney diseases ; Kidney transplantation ; Laboratories ; Male ; Mathematical models ; Medical referrals ; Medicine and Health Sciences ; Middle Aged ; Morbidity ; Mortality ; National health insurance ; Nephrology ; Nephropathy ; Patients ; Physical Sciences ; Population ; Population studies ; Primary care ; Referral and Consultation - statistics & numerical data ; Renal function ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - etiology ; Research and Analysis Methods ; Statistical methods ; Statistics, Nonparametric ; Surveys ; Time Factors ; Transplants & implants</subject><ispartof>PloS one, 2014-11, Vol.9 (11), p.e112767-e112767</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Sombolos et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Sombolos et al 2014 Sombolos et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4bc36178f1e0ab3f2c8218c53e27c0ac9bf38d83eac97d30c7e37bedc563708b3</citedby><cites>FETCH-LOGICAL-c692t-4bc36178f1e0ab3f2c8218c53e27c0ac9bf38d83eac97d30c7e37bedc563708b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236082/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236082/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25406080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Burdmann, Emmanuel A.</contributor><creatorcontrib>Sombolos, Konstantinos</creatorcontrib><creatorcontrib>Tsakiris, Demitrios</creatorcontrib><creatorcontrib>Boletis, John</creatorcontrib><creatorcontrib>Vlahakos, Demetrios</creatorcontrib><creatorcontrib>Siamopoulos, Kostas C</creatorcontrib><creatorcontrib>Vargemezis, Vassilios</creatorcontrib><creatorcontrib>Nikolaidis, Pavlos</creatorcontrib><creatorcontrib>Iatrou, Christos</creatorcontrib><creatorcontrib>Dafnis, Eugene</creatorcontrib><creatorcontrib>Xynos, Konstantinos</creatorcontrib><creatorcontrib>Argyropoulos, Christos</creatorcontrib><title>Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Chronic Kidney Disease (CKD) is a relatively common condition not only associated with increased morbidity and mortality but also fuelling End Stage Renal Disease (ESRD). Among developed nations, Greece has one of the highest ESRD incidence rates, yet there is limited understanding of the epidemiology of earlier stages of CKD.
Cross-sectional survey of pre-dialysis CKD outpatients in nephrology clinics in the National Health Care system between October 2009 and October 2010. Demographics, cause of CKD, blood pressure, level of renal function, duration of CKD and nephrology care, and specialty of referral physician were collected and analyzed. Different methods for estimating renal function (Cockroft-Gault [CG], CKD-Epi and MDRD) and staging CKD were assessed for agreement.
A total of 1,501 patients in 9 centers were enrolled. Diabetic nephropathy was the most common nephrologist assigned cause of CKD (29.7%). In total, 36.5% of patients had self-referred to the nephrologist; patients with diabetes or serum creatinine above 220 µmol/l (eGFR<40 ml/min/1.73 m2) were more likely to have been referred by a physician. Agreement between MDRD and CKD-Epi, but not between CG, the other estimating equations, was excellent. There was substantial heterogeneity with respect to renal diagnoses, referral patterns and blood pressure among participating centers.
In this first epidemiologic assessment of CKD in Greece, we documented delayed referral and high rates of self-referral among patients with CKD. eGFR reporting, currently offered by a limited number of laboratories, may facilitate detection of CKD at an earlier, more treatable stage.</description><subject>Adult</subject><subject>Aged</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Blood Pressure</subject><subject>Chronic kidney failure</subject><subject>Clinics</subject><subject>Creatinine</subject><subject>Creatinine - blood</subject><subject>Cross-Sectional Studies</subject><subject>Demographics</subject><subject>Demography</subject><subject>Developed countries</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetic nephropathies</subject><subject>Diabetic Nephropathies - complications</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic nephropathy</subject><subject>Dialysis</subject><subject>Epidemiology</subject><subject>Epidermal growth factor receptors</subject><subject>Estimation</subject><subject>Female</subject><subject>Greece - epidemiology</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Hemodialysis</subject><subject>Heterogeneity</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Kidney - physiology</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medical referrals</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>National health insurance</subject><subject>Nephrology</subject><subject>Nephropathy</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Population</subject><subject>Population studies</subject><subject>Primary care</subject><subject>Referral and Consultation - statistics & numerical data</subject><subject>Renal function</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Research and Analysis Methods</subject><subject>Statistical methods</subject><subject>Statistics, Nonparametric</subject><subject>Surveys</subject><subject>Time Factors</subject><subject>Transplants & implants</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk19v0zAUxSMEYmPwDRBYQkLw0OI_ie3sAakqY1QMDXWDV8txbtpMbhzsBLFvj9tmU4P2gPIQx_mdY_v43iR5SfCUMEE-3LjeN9pOW9fAFBNCBRePkmOSMzrhFLPHB-Oj5FkINxhnTHL-NDmiWYo5lvg46b71tqsNNB14BG1dwqZ21q1qoy0KXV_eos4hHQKEgLo1oNa1vdVd7RrkKjT_-gm18SvqA6obdO4BDJwiDyH6BlR5t9nJvi_Prq5ny73l8-RJpW2AF8P7JPnx-ex6_mVycXm-mM8uJobntJukhWGcCFkRwLpgFTWSEmkyBlQYrE1eVEyWkkEcipJhI4CJAkqTcSawLNhJ8nrv21oX1BBYUITTTMqU5VkkFnuidPpGtb7eaH-rnK7VbsL5ldI-5mNB8QKoFDjFOUnTPDeSE0woKWmFqcy4iV4fh9X6YhN3ETPx2o5Mx3-aeq1W7rdKKYuXQaPBu8HAu189hE5t6mDAWt2A63f7FlikgrCIvvkHffh0A7XS8QB1U7m4rtmaqllKJInVgPNITR-g4rOtBROrq6rj_EjwfiSITAd_upXuQ1CLq-X_s5c_x-zbA3YN2nbr4Gy_LbYwBtM9aLwLwUN1HzLBatscd2mobXOooTmi7NXhBd2L7rqB_QWe6QlC</recordid><startdate>20141118</startdate><enddate>20141118</enddate><creator>Sombolos, Konstantinos</creator><creator>Tsakiris, Demitrios</creator><creator>Boletis, John</creator><creator>Vlahakos, Demetrios</creator><creator>Siamopoulos, Kostas C</creator><creator>Vargemezis, Vassilios</creator><creator>Nikolaidis, Pavlos</creator><creator>Iatrou, Christos</creator><creator>Dafnis, Eugene</creator><creator>Xynos, Konstantinos</creator><creator>Argyropoulos, Christos</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20141118</creationdate><title>Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study</title><author>Sombolos, Konstantinos ; Tsakiris, Demitrios ; Boletis, John ; Vlahakos, Demetrios ; Siamopoulos, Kostas C ; Vargemezis, Vassilios ; Nikolaidis, Pavlos ; Iatrou, Christos ; Dafnis, Eugene ; Xynos, Konstantinos ; Argyropoulos, Christos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4bc36178f1e0ab3f2c8218c53e27c0ac9bf38d83eac97d30c7e37bedc563708b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Blood Pressure</topic><topic>Chronic kidney failure</topic><topic>Clinics</topic><topic>Creatinine</topic><topic>Creatinine - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sombolos, Konstantinos</au><au>Tsakiris, Demitrios</au><au>Boletis, John</au><au>Vlahakos, Demetrios</au><au>Siamopoulos, Kostas C</au><au>Vargemezis, Vassilios</au><au>Nikolaidis, Pavlos</au><au>Iatrou, Christos</au><au>Dafnis, Eugene</au><au>Xynos, Konstantinos</au><au>Argyropoulos, Christos</au><au>Burdmann, Emmanuel A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-11-18</date><risdate>2014</risdate><volume>9</volume><issue>11</issue><spage>e112767</spage><epage>e112767</epage><pages>e112767-e112767</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Chronic Kidney Disease (CKD) is a relatively common condition not only associated with increased morbidity and mortality but also fuelling End Stage Renal Disease (ESRD). Among developed nations, Greece has one of the highest ESRD incidence rates, yet there is limited understanding of the epidemiology of earlier stages of CKD.
Cross-sectional survey of pre-dialysis CKD outpatients in nephrology clinics in the National Health Care system between October 2009 and October 2010. Demographics, cause of CKD, blood pressure, level of renal function, duration of CKD and nephrology care, and specialty of referral physician were collected and analyzed. Different methods for estimating renal function (Cockroft-Gault [CG], CKD-Epi and MDRD) and staging CKD were assessed for agreement.
A total of 1,501 patients in 9 centers were enrolled. Diabetic nephropathy was the most common nephrologist assigned cause of CKD (29.7%). In total, 36.5% of patients had self-referred to the nephrologist; patients with diabetes or serum creatinine above 220 µmol/l (eGFR<40 ml/min/1.73 m2) were more likely to have been referred by a physician. Agreement between MDRD and CKD-Epi, but not between CG, the other estimating equations, was excellent. There was substantial heterogeneity with respect to renal diagnoses, referral patterns and blood pressure among participating centers.
In this first epidemiologic assessment of CKD in Greece, we documented delayed referral and high rates of self-referral among patients with CKD. eGFR reporting, currently offered by a limited number of laboratories, may facilitate detection of CKD at an earlier, more treatable stage.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25406080</pmid><doi>10.1371/journal.pone.0112767</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2014-11, Vol.9 (11), p.e112767-e112767 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1625884395 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Aged Biology and Life Sciences Blood Blood Pressure Chronic kidney failure Clinics Creatinine Creatinine - blood Cross-Sectional Studies Demographics Demography Developed countries Diabetes Diabetes mellitus Diabetic nephropathies Diabetic Nephropathies - complications Diabetic Nephropathies - epidemiology Diabetic nephropathy Dialysis Epidemiology Epidermal growth factor receptors Estimation Female Greece - epidemiology Health aspects Health care Hemodialysis Heterogeneity Hospitals Humans Kidney - physiology Kidney diseases Kidney transplantation Laboratories Male Mathematical models Medical referrals Medicine and Health Sciences Middle Aged Morbidity Mortality National health insurance Nephrology Nephropathy Patients Physical Sciences Population Population studies Primary care Referral and Consultation - statistics & numerical data Renal function Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - etiology Research and Analysis Methods Statistical methods Statistics, Nonparametric Surveys Time Factors Transplants & implants |
| title | Multicenter epidemiological study to assess the population of CKD patients in Greece: results from the PRESTAR study |
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