Professional paper
PATIENTS REFERRED TO NEPHROLOGY SPECIALIST WITH INCOMPLETE DIAGNOSTIC WORKUP – HOW BIG IS THE PROBLEM?
JURAJ JUG
orcid.org/0000-0002-3189-1518
; Health Center Zagreb West, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
ĐIĐI DELALIĆ
; School of Medicine, University of Zagreb, Zagreb, Croatia
MARTINA PETRINOVIĆ
; School of Medicine, University of Zagreb, Zagreb, Croatia
DORA MEŠTROVIĆ
; School of Medicine, University of Zagreb, Zagreb, Croatia
INGRID PRKAČIN
; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Internal Medicine, Merkur University Hospital, Zagreb, Croatia
Abstract
In daily work, we notice an increasing number of patients referred to a nephrologist without diagnostic tests necessary for proper assessment and treatment plan. Our aim was to show how many patients are referred to a nephrology specialist for the fi rst time with complete diagnostic workup. We included 184 patients (89 male and 95 female) newly referred to the Merkur University Hospital nephrology specialist due to chronic kidney disease (CKD, stages 3A and above) from 2017 until 2020. We analyzed blood pressure values, 24-h ambulatory blood pressure monitor (ABPM) and laboratory test results (hemoglobin, hematocrit, glucose, potassium, creatinine, sodium, cholesterol, calcium, urates, and urine) of patients having presented them at the check-up. Most of the referred patients had CKD stage G3 (G3A 15 patients, G3B 82 patients, 52.15%), while 71 (38.17%) patients had CKD stage G4 and 18 (9.67%) patients CKD stage 5. Women were statistically signifi cantly older (74.08 vs. 70.49 years, p<0.05) with higher heart rate (76.11 vs. 70.76 bpm, p<0.05) than men. Although 160 (86.02%) patients had verifi ed arterial hypertension, only 44 (23.66%) patients had ABPM results. Ninety (48.39%) patients had their urate levels measured; 104 patients had their urine analyzed, of which 28 (26.92%) patients had no albumin values, and 76 had albumin values measured in urine (A1 (8.65%), A2 (51.92%), and A3 (12.50%)). Hematuria was found in 49 (47.11%) patients. Only 14.52% of patients referred for the fi rst time to the nephrology specialist had complete diagnostic test results mandatory for successful fi rst clinical check-up. Multicenter data should be obtained to get more consistent results.
Keywords
chronic kidney disease; primary care physicians; referral to nephrologist
Hrčak ID:
280221
URI
Publication date:
7.7.2022.
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