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Women with Chronic Kidney Disease more
likely than men to go undiagnosed
Newswise — Woman are at particular risk of
their primary care physicians delaying
diagnosis of chronic kidney disease (CKD),
according to a paper being presented at the
American Society of Nephrology’s 42nd Annual
Meeting and Scientific Exposition in San
Diego, California.
The findings suggest that educating
practitioners about CKD could increase the
timely diagnosis of CKD, thereby leading to
improvements in care to patients and savings
in Medicare dollars.
Maya Rao, MD, of Columbia University,
reviewed records from nearly 900 patients at
18 rural, community-based primary care
clinics in Oregon, to investigate whether
primary care physicians accurately diagnosed
CKD in patients with known kidney
dysfunction.
Chronic kidney disease is estimated to
affect up to 19 million adults in the U.S.
and is usually diagnosed and treated in the
primary care setting. The analysis showed
that 52.4 percent of patients found to have
CKD did not have a diagnosis in their
charts. Females were more likely to be
undiagnosed than males, except at the most
advanced stages of CKD.
“Chronic kidney disease is very prevalent,
uses a great deal of Medicare dollars and
needs to be detected early in order to begin
an effective treatment plan. Without early
diagnosis and treatment, the patient may be
more likely to need dialysis and suffer
related consequences, such as heart
disease,” said Dr. Rao.
“This study shows that CKD is still being
missed by primary care physicians,
especially among women patients, and that
more education is needed to ultimately
improve early detection and diagnosis.”
To measure kidney function, primary care
doctors typically order a blood test called
creatinine, but Dr. Rao says this alone is
not a particularly accurate measure of
kidney function.
The serum creatinine should also be plugged
into a formula that gives an estimated
kidney filtration rate (called glomerular
filtration rate, or eGFR) which is a much
more accurate estimate of kidney function.
Women have a lower eGFR than men for the
same level of serum creatinine.
Thus, the same serum creatinine level that
initially appears normal for both a man and
a woman can translate into depressed kidney
function for the woman, making her at higher
risk for undetected kidney disease.
In the study, lab reports that automatically
included the eGFR calculation did not show a
gender disparity in diagnosis of patients –
suggesting that including this value on all
serum creatinine lab reports could improve
diagnosis of CKD in women.
Study co-authors include Sharon Anderson,
MD, FASN and Cynthia Morris, PhD, MPH, both
of Oregon Health and Science University. The
authors report no financial disclosures. Dr.
Anderson is President-Elect of the American
Society of Nephrology.
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