Underestimated incidence of kidney disease in nonrenal outpatient

Area of Science:

• Nephrology
• Public Health
• Internal Medicine

Background:

• Chronic kidney disease (CKD) poses a significant public health threat, often developing secondary to other conditions.
• Serum creatinine (SCr) is a common marker for renal function but may not accurately reflect glomerular filtration rate (GFR).
• Prevalence of kidney disease in non-renal departments needs investigation to inform kidney injury prevention strategies.

Purpose of the Study:

• To investigate the prevalence of kidney disease among outpatients in non-renal departments.
• To provide data for the prevention of kidney injury in diverse patient populations.
• To assess the accuracy of serum creatinine in reflecting kidney function in these patients.

Main Methods:

• A cross-sectional study involving 17,462 outpatients from cardiology, endocrinology, and neurology departments across 16 hospitals.
• Screening for kidney disease incidence using estimated GFR (eGFR) calculated with the MDRD formula.
• Analysis of eGFR in relation to normal SCr levels and comorbidities like hypertension and diabetes.

Main Results:

• 23% of outpatients had an eGFR below 60 mL/min/1.73 m², with 80 patients having eGFR < 15 mL/min/1.73 m².
• Among patients with normal SCr levels, 3209 (approximately 19.3%) had an eGFR < 60 mL/min/1.73 m².
• Hypertension and diabetes were associated with a high prevalence of reduced renal function.

Conclusions:

• Kidney injury is widespread among non-renal outpatients.
• The incidence of chronic kidney disease (CKD) is likely underestimated in the general patient population.
• Routine eGFR assessment in non-renal departments is crucial for early detection and management of kidney disease.