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Spectral Karyotyping to Study Chromosome Abnormalities in Humans and Mice with Polycystic Kidney Disease
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Testing Patterns for CKD-MBD Abnormalities in a Sample US Population.

James B Wetmore1,2, Yuanyuan Ji1, Akhtar Ashfaq3

  • 1Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.

Kidney International Reports
|April 29, 2021
PubMed
Summary
This summary is machine-generated.

Testing and retesting for chronic kidney disease mineral bone disorder (CKD-MBD) appear suboptimal. Few patients with CKD stages 4 and 5 received recommended parathyroid hormone (PTH) and 25D testing, and posttreatment retesting rates were low.

Keywords:
25Dchronic kidney diseasemineral/bone disorderparathyroid hormonephosphorus

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Area of Science:

  • Nephrology
  • Endocrinology
  • Public Health

Background:

  • Chronic kidney disease mineral bone disorder (CKD-MBD) management guidelines exist but their adherence is not well-documented.
  • Large-scale electronic health record data offers a unique opportunity to study CKD-MBD testing and treatment patterns.

Purpose of the Study:

  • To evaluate the concordance with CKD-MBD management guidelines.
  • To analyze testing, treatment, and retesting patterns in CKD patients.
  • To identify predictors of posttreatment retesting.

Main Methods:

  • Utilized 2010-2019 electronic health record data from over 50 million patients.
  • Created cohorts of CKD stages 3, 4, and 5 patients based on diagnosis codes and eGFR.
  • Assessed CKD-MBD test ordering, drug prescribing, and retesting rates using multivariable Cox regression.

Main Results:

  • Only 46% of stage 4 and 41% of stage 5 CKD patients received PTH testing.
  • Posttreatment retesting for PTH and 25D within one year was suboptimal across all CKD stages.
  • Pretreatment PTH and 25D levels did not consistently predict likelihood of retesting.

Conclusions:

  • Testing frequency for CKD-MBD abnormalities is suboptimal.
  • Posttreatment retesting rates for CKD-MBD are insufficient.
  • Current CKD-MBD management may not align with established guidelines.