Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries
Introduction: The uptake of the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 chronic kidney disease (CKD) Guideline is not fully described in real-world nephrology practice across the world. Methods: We used baseline data from the CKD Outcomes and Practice Patterns Study (2013–2017), a 4-c...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | Kidney International Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024920317964 |
| _version_ | 1818614028826574848 |
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| author | Bénédicte Stengel Daniel Muenz Charlotte Tu Elodie Speyer Natalia Alencar de Pinho Christian Combe Kunihiro Yamagata Helmut Reichel Danilo Fliser Ziad A. Massy Antonio A. Lopes Michel Jadoul Wolfgang C. Winkelmayer Ronald L. Pisoni Bruce M. Robinson Roberto Pecoits-Filho Antonio Lopes Roberto Pecoits-Filho Christian Combe Christian Jacquelinet Ziad Massy Bénédicte Stengel Johannes Duttlinger Danilo Fliser Gerhard Lonnemann Helmut Reichel Takashi Wada Kunihiro Yamagata Ron Pisoni Bruce Robinson Viviane Calice da Silva Ricardo Sesso Elodie Speyer Koichi Asahi Junichi Hoshino Ichiei Narita Rachel Perlman Friedrich Port Nidhi Sukul Michelle Wong Eric Young Jarcy Zee |
| author_facet | Bénédicte Stengel Daniel Muenz Charlotte Tu Elodie Speyer Natalia Alencar de Pinho Christian Combe Kunihiro Yamagata Helmut Reichel Danilo Fliser Ziad A. Massy Antonio A. Lopes Michel Jadoul Wolfgang C. Winkelmayer Ronald L. Pisoni Bruce M. Robinson Roberto Pecoits-Filho Antonio Lopes Roberto Pecoits-Filho Christian Combe Christian Jacquelinet Ziad Massy Bénédicte Stengel Johannes Duttlinger Danilo Fliser Gerhard Lonnemann Helmut Reichel Takashi Wada Kunihiro Yamagata Ron Pisoni Bruce Robinson Viviane Calice da Silva Ricardo Sesso Elodie Speyer Koichi Asahi Junichi Hoshino Ichiei Narita Rachel Perlman Friedrich Port Nidhi Sukul Michelle Wong Eric Young Jarcy Zee |
| author_sort | Bénédicte Stengel |
| collection | DOAJ |
| description | Introduction: The uptake of the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 chronic kidney disease (CKD) Guideline is not fully described in real-world nephrology practice across the world. Methods: We used baseline data from the CKD Outcomes and Practice Patterns Study (2013–2017), a 4-country cohort of patients with estimated glomerular filtration rate <60 ml/min per 1.73 m2 recruited from national samples of nephrology clinics, to describe adherence to measures for monitoring and delaying CKD progression. Data were collected as in clinical practice, except laboratory measures per protocol in France. Results: The mean age ranged from 65 years in Brazil to 72 years in Germany. Albuminuria (mostly proteinuria) was measured routinely in 36% to 43% of patients in Brazil, Germany, and the United States. Blood pressure control (≤140/90 mm Hg) ranged from 49% in France to 76% in Brazil; <40% of patients had blood pressure ≤130/80 mm Hg everywhere but Brazil (52%). More than 40% of nephrologists in Brazil reported a systolic blood pressure target ≤130 mm Hg for nondiabetic patients without proteinuria, but only 19% to 24% elsewhere. Prescription of renin-angiotensin aldosterone system inhibitors ranged from 52% in the United States to 81% in Germany. Dietary advice was more frequent for salt than protein intake; dietitian visits were uncommon. In nondiabetic patients, achievement of all 3 targets including blood pressure ≤130/80 mm Hg, renin-angiotensin aldosterone system inhibition, and dietary advice, ranged from 10% in the United States to 32% in Brazil; in treated diabetic patients, this ranged from 6% to 11% after including hemoglobin A1c target. Conclusion: Adherence to recommendations to slow CKD progression is low in typical practice settings, and substantial variation among countries for some indicates opportunities for improvement. |
| first_indexed | 2024-12-16T16:11:30Z |
| format | Article |
| id | doaj.art-d182a6f118ab4378b72772c82361e643 |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-12-16T16:11:30Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-d182a6f118ab4378b72772c82361e6432022-12-21T22:25:12ZengElsevierKidney International Reports2468-02492021-02-0162437448Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across CountriesBénédicte Stengel0Daniel Muenz1Charlotte Tu2Elodie Speyer3Natalia Alencar de Pinho4Christian Combe5Kunihiro Yamagata6Helmut Reichel7Danilo Fliser8Ziad A. Massy9Antonio A. Lopes10Michel Jadoul11Wolfgang C. Winkelmayer12Ronald L. Pisoni13Bruce M. Robinson14Roberto Pecoits-Filho15Antonio LopesRoberto Pecoits-FilhoChristian CombeChristian JacquelinetZiad MassyBénédicte StengelJohannes DuttlingerDanilo FliserGerhard LonnemannHelmut ReichelTakashi WadaKunihiro YamagataRon PisoniBruce RobinsonViviane Calice da SilvaRicardo SessoElodie SpeyerKoichi AsahiJunichi HoshinoIchiei NaritaRachel PerlmanFriedrich PortNidhi SukulMichelle WongEric YoungJarcy ZeeCentre for Research in Epidemiology and Population Health, Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France; Correspondence: Bénédicte Stengel, Centre for Research in Epidemiology and Population Health, INSERM U1018, Clinical Epidemiology Team, 16 avenue P. Vaillant Couturier, 94807 Villejuif, France.Arbor Research Collaborative for Health, Ann Arbor, Michigan, USAArbor Research Collaborative for Health, Ann Arbor, Michigan, USACentre for Research in Epidemiology and Population Health, Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, FranceCentre for Research in Epidemiology and Population Health, Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, FranceService de Néphrologie Transplantation Dialyse Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; INSERM U1026, Université Bordeaux Segalen, Bordeaux, FranceDepartment of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, JapanNephrological Center, Villingen-Schwenningen, GermanyDepartment of Internal Medicine IV, Saarland University Medical Center, Homburg, GermanyCentre for Research in Epidemiology and Population Health, Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Villejuif, France; Department of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, FranceDepartment of Internal Medicine, Federal University of Bahia, Salvador, BrazilDepartment of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, BelgiumSection for Nephrology and Selzman Institute for Kidney Health, Baylor College of Medicine, Houston, Texas, USAArbor Research Collaborative for Health, Ann Arbor, Michigan, USAArbor Research Collaborative for Health, Ann Arbor, Michigan, USAArbor Research Collaborative for Health, Ann Arbor, Michigan, USA; School of Medicine, Pontificia Universidade Catolica do Parana, BrazilIntroduction: The uptake of the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 chronic kidney disease (CKD) Guideline is not fully described in real-world nephrology practice across the world. Methods: We used baseline data from the CKD Outcomes and Practice Patterns Study (2013–2017), a 4-country cohort of patients with estimated glomerular filtration rate <60 ml/min per 1.73 m2 recruited from national samples of nephrology clinics, to describe adherence to measures for monitoring and delaying CKD progression. Data were collected as in clinical practice, except laboratory measures per protocol in France. Results: The mean age ranged from 65 years in Brazil to 72 years in Germany. Albuminuria (mostly proteinuria) was measured routinely in 36% to 43% of patients in Brazil, Germany, and the United States. Blood pressure control (≤140/90 mm Hg) ranged from 49% in France to 76% in Brazil; <40% of patients had blood pressure ≤130/80 mm Hg everywhere but Brazil (52%). More than 40% of nephrologists in Brazil reported a systolic blood pressure target ≤130 mm Hg for nondiabetic patients without proteinuria, but only 19% to 24% elsewhere. Prescription of renin-angiotensin aldosterone system inhibitors ranged from 52% in the United States to 81% in Germany. Dietary advice was more frequent for salt than protein intake; dietitian visits were uncommon. In nondiabetic patients, achievement of all 3 targets including blood pressure ≤130/80 mm Hg, renin-angiotensin aldosterone system inhibition, and dietary advice, ranged from 10% in the United States to 32% in Brazil; in treated diabetic patients, this ranged from 6% to 11% after including hemoglobin A1c target. Conclusion: Adherence to recommendations to slow CKD progression is low in typical practice settings, and substantial variation among countries for some indicates opportunities for improvement.http://www.sciencedirect.com/science/article/pii/S2468024920317964albuminuriablood pressure controlchronic kidney diseasedietary advicelifestylerenin-angiotensin system inhibition |
| spellingShingle | Bénédicte Stengel Daniel Muenz Charlotte Tu Elodie Speyer Natalia Alencar de Pinho Christian Combe Kunihiro Yamagata Helmut Reichel Danilo Fliser Ziad A. Massy Antonio A. Lopes Michel Jadoul Wolfgang C. Winkelmayer Ronald L. Pisoni Bruce M. Robinson Roberto Pecoits-Filho Antonio Lopes Roberto Pecoits-Filho Christian Combe Christian Jacquelinet Ziad Massy Bénédicte Stengel Johannes Duttlinger Danilo Fliser Gerhard Lonnemann Helmut Reichel Takashi Wada Kunihiro Yamagata Ron Pisoni Bruce Robinson Viviane Calice da Silva Ricardo Sesso Elodie Speyer Koichi Asahi Junichi Hoshino Ichiei Narita Rachel Perlman Friedrich Port Nidhi Sukul Michelle Wong Eric Young Jarcy Zee Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries Kidney International Reports albuminuria blood pressure control chronic kidney disease dietary advice lifestyle renin-angiotensin system inhibition |
| title | Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries |
| title_full | Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries |
| title_fullStr | Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries |
| title_full_unstemmed | Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries |
| title_short | Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries |
| title_sort | adherence to the kidney disease improving global outcomes ckd guideline in nephrology practice across countries |
| topic | albuminuria blood pressure control chronic kidney disease dietary advice lifestyle renin-angiotensin system inhibition |
| url | http://www.sciencedirect.com/science/article/pii/S2468024920317964 |
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