Table 3.
Measures of Management of Chronic Kidney Disease by Prior Contact with a Nephrologist Over Three Ranges of Estimated Glomerula Filtration Rate
| eGFR 15– < 30 ml/min/1.73 m2 | eGFR 30– < 60 ml/min/1.73 m2 | eGFR ≥ 60 ml/min/1.73 m2 | ||||
|---|---|---|---|---|---|---|
| Prior Contact with Nephrologist | ||||||
| Variables | Yes (n = 705) | No (n = 87) | Yes (n = 1597) | No (n = 778) | Yes (n = 289) | No (n = 399) |
| Systolic BP, mm Hg | 133 (24) | 133 (22) | 128 (22) | 130 (23) | 121 (18) | 122 (19) |
| At goal (< 130/80 mm Hg) | 48 % (337/705) | 45 % (39/87) | 57 % (908/1596) | 53 % (410/778) | 74 % (213/289) | 72 % (289/399) |
| Treateda and at goal | 48 % (324/681) | 47 % (39/83) | 56 % (848/1511) | 53 % (386/734) | 71 % (167/235) | 66 %(178/271) |
| Bicarbonate, mEq/L | 23 (3) | 23 (4) | 24 (3)* | 25 (3)* | 26 (3) | 26 (3) |
| At goal (≥ 22 mEq/L) | 64 % (451/698) | 63 % (55/87) | 84 % (1340/1585) | 86 % (669/773) | 91 % (262/281) | 94 % (376/397) |
| Treatedb and at goal | 65 % (26/40)* | 0* | 73 % (16/22) | 50 % (2/4) | 50 % (1/2) | 0 |
| Phosphate, mg/dL | 4.1 (1) | 4.2 (1) | 3.7 (1) | 3.7 (1) | 3.4 (1)* | 3.5 (1)* |
| At goal (2.7–4.6 mg/dL) | 75 % (530/687) | 71 % (62/87) | 89 % (1423/1574) | 90 % (697/766) | - | - |
| Treatedc and at goal | 75 % (64/85)* | 46 % (5/11)* | 88 % (87/99) | 79 % (33/42) | - | - |
| iPTH | 109 (67–176) | 92 (61–159) | 55 (36–84) | 49 (33–74) | 36 (28–51) | 35 (27–47) |
| At goale (not on treatment) | 24 % (136/564)* | 37 % (28/75)* | 39 % (572/1458) | 43 % (317/736) | - | - |
| Treatedd and at goale | 53 % (75/141) | 58 % (7/12) | 48 % (66/139) | 62 % (26/42) | - | - |
| Hemoglobin, g/dl | 11.7 (1.7) | 11.5 (1.6) | 12.7 (1.7)* | 12.5 (1.7)* | 13.9 (1.6)* | 13.4 (1.5)* |
| At goal (11–12 g/dl, not on treatment) | 91 % (480/528)* | 85 % (66/78)* | 96 % (1366/1422) | 95 % (689/729) | 97 % (267/275) | 98 % (370/377) |
| Treatedf and at goal | 57 % (100/177) | 67 % (6/9) | 49 % (86/175) | 39 % (19/49) | 21 % (3/14) | 41 % (9/22) |
| ACEi or ARB use | 67 % (473/702) | 74 % (64/87) | 76 % (1199/1585)* | 71 % (550/771)* | 60 % (173/287)* | 46 % (181/396)* |
Values are expressed as mean (standard deviation), median (interquartile range), or % (numerator/denominator). For systolic BP, bicarbonate and phosphate, the “at goal” category includes individuals with and without treatment
ACEi angiotensin converting enzyme inhibitor; ARB angiotensin receptor blocker; BP blood pressure; iPTH intact parathyroid hormone
aUse of any antihypertensive medication
bUse of sodium bicarbonate, potassium bicarbonate or sodium citrate
cUse of any phosphorus binder
dUse of a phosphorus binder, active vitamin D formulation or cinacalcet
eiPTH (pg/ml) treatment goal based on eGFR: 70–110 (eGFR 15–30); 30–59 (eGFR 30–60)
fUse of an erythropoietin stimulating agent or iron
*p < 0.05