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Diabetes and renal disease: who does what?

Jones, Ruth K., Hampton, D., O'Sullivan, D. J. and Phillips, Aled Owain 2013. Diabetes and renal disease: who does what? Clinical Medicine 13 (5) , pp. 460-464. 10.7861/clinmedicine.13-5-460

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Abstract

Care of patients with diabetes and chronic kidney disease (CKD) in the UK is divided between primary care, diabetologists and nephrology. In a retrospective analysis, we examined the distribution of care provision for patients with diabetes and CKD. Nephrology services see a minority of diabetic patients with CKD, but they see the majority of those with an estimated glomerular filtration rate (eGFR) of <30 ml/min. Of those followed in nephrology, 70% showed no evidence of progressive renal dysfunction. The nephrology cohort were significantly younger that those seen by primary care physicians or diabetologists. Half of the patients with diabetes and CKD seen in either the primary care and diabetology cohorts, with no nephrology input, had a rate of fall of eGFR of >5 ml/min/yr. This suggests that older age might deter referral to nephrology, which is based predominantly on CKD stage. This results in a significant proportion of patients with stable renal function being seen by nephrology, and in the under-referral of a large cohort of patients with progressive CKD.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Postgraduate Medical and Dental Education
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
Uncontrolled Keywords: Chronic kidney disease; CKD; diabetes; epidemiology; nephropathy
Publisher: Royal College of Physicians
ISSN: 1470-2118
Last Modified: 19 Oct 2017 21:46
URI: http://orca.cf.ac.uk/id/eprint/61502

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