scholarly journals Can the height-independent Pottel eGFR equation be used as a screening tool for chronic kidney disease in children?

2015 ◽  
Vol 174 (9) ◽  
pp. 1225-1235 ◽  
Author(s):  
Vandréa De Souza ◽  
Hans Pottel ◽  
Liesbeth Hoste ◽  
Olga Dolomanova ◽  
Regine Cartier ◽  
...  
2016 ◽  
Vol 44 (4) ◽  
pp. 308-315 ◽  
Author(s):  
Zoe G. Smith ◽  
Lynn McNicoll ◽  
Timothy L. Clark ◽  
Andrew J. Cohen ◽  
Antonia L. Ross ◽  
...  

Background: The patient-centered medical home is a popular model of care, but the patient-centered medical neighborhood (PCMN) is rarely described. We developed a PCMN in an academic practice to improve care for patients with chronic kidney disease (CKD). The purpose of this study is to identify the prevalence of CKD in this practice and describe baseline characteristics, develop an interdisciplinary team-based approach to care and determine cost associated with CKD patients. Methods: Patients with CKD stage 3a with comorbidities through stage 5 were identified. Data collected include demographics, comorbidities and whether patients had a nephrologist. Using a screening tool based on the 2012 Kidney Disease Improving Global Outcomes guidelines, a nurse care manager (NCM) made recommendations about management including indications for referral. A pharmacist reviewed patients' charts and made medication-related recommendations. Blue Cross Blue Shield (BCBS) insurance provided cost data for a subset of patients. Results: A total of 1,255 patients were identified. Half did not have a formal diagnosis of CKD and three-quarters had never seen a nephrologist. Based on the results of the screening tool, the NCM recommended nephrology E-consult or full consult for 85 patients. The subset of BCBS patients had a mean healthcare cost of $1,528.69 per member per month. Conclusions: We implemented a PCMN that allowed for easy identification of a high-risk, high-cost population of CKD patients and optimized their care to reflect guideline-based standards.


2015 ◽  
Vol 26 (6) ◽  
pp. 1311
Author(s):  
Anita Saxena ◽  
Amit Gupta ◽  
Georgi Abraham ◽  
Vinay Sakhuja ◽  
V Jha

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Julie A Wright Nunes ◽  
Cheryl A M Anderson ◽  
Jane H Greene ◽  
Talat Alp Ikizler ◽  
Kerri L Cavanaugh

Author(s):  
Anja Vukomanović ◽  
Ivica Vrdoljak ◽  
Ines Panjkota Krbavčić ◽  
Tea Vrdoljak Margeta ◽  
Martina Bituh

Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice. The new recommendations defined the 7-point Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease (CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous survey-based tools for screening nutritional status (Malnutrition Screening Tool – MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished (MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with 7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals.


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