TY - JOUR
T1 - Awareness and Knowledge of Clinical Practice Guidelines for CKD Among Internal Medicine Residents
T2 - A National Online Survey
AU - Agrawal, Varun
AU - Ghosh, Amit K.
AU - Barnes, Michael A.
AU - McCullough, Peter A.
N1 - Funding Information:
Support: This study was supported by a minigrant from the Beaumont Research Institute, Royal Oak, MI.
PY - 2008/12
Y1 - 2008/12
N2 - Background: The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care physicians who are less experienced than nephrologists to offer optimal pre-end-stage renal disease care. It is not known whether current postgraduate training adequately prepares a future internist in CKD management. Study Design: Cross-sectional study using an online questionnaire survey. Setting & Participants: Internal medicine residents in the United States (n = 479) with postgraduate year (PGY) distribution of 166 PGY1, 187 PGY2, and 126 PGY3. Predictor: Awareness and knowledge of CKD clinical practice guidelines measured by using the questionnaire instrument. Outcomes & Measurements: Total performance score (maximum = 30). Results: Half the residents did not know that the presence of kidney damage (proteinuria) for 3 or more months defines CKD. One-third of the residents did not know the staging of CKD. All residents (99%) knew the traditional risk factors for CKD of diabetes and hypertension, but were less aware of other risk factors of obesity (38%), elderly age (71%), and African American race (68%). Most residents (87%) were aware of estimated glomerular filtration rate in the evaluation of patients with CKD. Most residents (90%) knew goal blood pressure (<130/80 mm Hg) for patients with CKD. Most residents identified anemia (91%) and bone disorder (82%) as complications of CKD, but only half recognized CKD as a risk factor for cardiovascular disease. Most residents (90%) chose to refer a patient with a glomerular filtration rate less than 30 mL/min/1.73 m2 to a nephrologist. A small improvement in mean performance score was observed with increasing PGY (PGY1, 68.8% ± 15.4%; PGY2, 72.9% ± 14.7%; and PGY3, 74.0% ± 12.0%; P = 0.004). Limitations: Self-selection, lack of nonrespondent data. Conclusions: Our survey identified specific gaps in knowledge of CKD guidelines in internal medicine residents. Educational efforts in increasing awareness of these guidelines may improve CKD management and clinical outcomes.
AB - Background: The National Kidney Foundation published Kidney Disease Outcomes Quality Initiative guidelines that recommend early detection and management of chronic kidney disease (CKD) and timely referral to a nephrologist. Many patients with CKD are seen by primary care physicians who are less experienced than nephrologists to offer optimal pre-end-stage renal disease care. It is not known whether current postgraduate training adequately prepares a future internist in CKD management. Study Design: Cross-sectional study using an online questionnaire survey. Setting & Participants: Internal medicine residents in the United States (n = 479) with postgraduate year (PGY) distribution of 166 PGY1, 187 PGY2, and 126 PGY3. Predictor: Awareness and knowledge of CKD clinical practice guidelines measured by using the questionnaire instrument. Outcomes & Measurements: Total performance score (maximum = 30). Results: Half the residents did not know that the presence of kidney damage (proteinuria) for 3 or more months defines CKD. One-third of the residents did not know the staging of CKD. All residents (99%) knew the traditional risk factors for CKD of diabetes and hypertension, but were less aware of other risk factors of obesity (38%), elderly age (71%), and African American race (68%). Most residents (87%) were aware of estimated glomerular filtration rate in the evaluation of patients with CKD. Most residents (90%) knew goal blood pressure (<130/80 mm Hg) for patients with CKD. Most residents identified anemia (91%) and bone disorder (82%) as complications of CKD, but only half recognized CKD as a risk factor for cardiovascular disease. Most residents (90%) chose to refer a patient with a glomerular filtration rate less than 30 mL/min/1.73 m2 to a nephrologist. A small improvement in mean performance score was observed with increasing PGY (PGY1, 68.8% ± 15.4%; PGY2, 72.9% ± 14.7%; and PGY3, 74.0% ± 12.0%; P = 0.004). Limitations: Self-selection, lack of nonrespondent data. Conclusions: Our survey identified specific gaps in knowledge of CKD guidelines in internal medicine residents. Educational efforts in increasing awareness of these guidelines may improve CKD management and clinical outcomes.
KW - Chronic kidney disease
KW - graduate medical education
KW - internal medicine residency
KW - practice guidelines
KW - questionnaire
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U2 - 10.1053/j.ajkd.2008.06.022
DO - 10.1053/j.ajkd.2008.06.022
M3 - Article
C2 - 18976845
AN - SCOPUS:56149091938
SN - 0272-6386
VL - 52
SP - 1061
EP - 1069
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 6
ER -