Many Doctors Still Miss Kidney Disease

New York, NY
October 16, 2006

Primary care physicians are less likely than other doctors to recognize when their patients have kidney disease, according to new study findings in the American Journal of Kidney Diseases – suggesting that many patients miss out on treatment in the early stages of the disease, when they have the best odds of avoiding or delaying complications.

“Early detection is the key to preventing or delaying complications of chronic kidney disease,” says Joseph Vassalotti, MD, the National Kidney Foundation Chief Medical Officer. “These findings demonstrate that patients at risk – including those with high blood pressure, diabetes, or a family history of kidney disease – need to be active participants in their healthcare. It may just save their lives.”

During the study, researchers at Johns Hopkins Medical Institutions surveyed 304 primary care doctors, including family doctors, internists and nephrologists (kidney specialists) about how they would diagnose and manage a fictitious 50 year-old woman. The patient had laboratory results consistent with moderate to severe chronic kidney disease (CKD), but doctors received only the results, without a diagnosis.

The study authors found that primary care physicians were much more likely to fail to recognize the patient had CKD. (In contrast, 98% of nephrologists correctly diagnosed the patient with moderate or severe CKD.) Primary care doctors were also more likely to say they were uncertain about which additional tests to recommend for the patient, and less likely to take the appropriate step of referring her to a nephrologist.

Family doctors who had spent at least 10 years in clinical practice were the least likely of all doctors to recognize the patient had CKD, suggesting that recently-trained doctors are more aware of current guidelines and recommendations for diagnosing and managing CKD.

“These findings show that experts need to target their education efforts to primary care doctors, particularly those who have been in practice for many years, so that no patient with CKD falls through the cracks,” says Joseph Vassalotti, MD, National Kidney Foundation Chief Medical Officer. “Everybody who believes they are at risk of CKD should know the risk factors, and ask to be tested regularly.”

For more information visit www.kidney.org.