ネフロロジーの診察とヘルスケアリソースの使用は,推定される球フィルタレーション率を報告する前と後に報告されます
Brenda R Hemmelgarn1, Jianguo Zhang, Braden J Manns
1Department of Medicine, University of Calgary, Calgary, Alberta, Canada. Brenda.Hemmelgarn@albertahealthservices.ca
JAMA
|March 25, 2010
まとめ
推定グルメルーラ濾過率 (eGFR) の検査報告は,慢性腎臓病 (CKD) の患者の腎臓科医の診察を増加させた. この傾向は,重度の腎機能不全,女性,高齢者において最も顕著であった. 患者のアウトカムへの影響を決定するためにさらなる研究が必要である.
科学分野:
- ネフロロジーは腎臓科です.
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
背景:
- 推定球濾過率 (eGFR) の検査報告は一般的ですが,過小評価されています.
- 医療利用に対するeGFR報告の影響を理解することは,患者管理において極めて重要です.
研究 の 目的:
- eGFR報告の実施後の腎臓科医の診察と医療資源の使用の変化を調査する.
- eGFR報告に関連する患者管理と専門家の紹介の傾向を分析する.
主な方法:
- カナダのアルバータ州で1,135,968人の参加者を対象としたコミュニティベースのコホート研究.
- タイムシリーズ分析は,eGFRの報告実施前と後の傾向を比較するために使用されました (2004年10月15日).
- データは2003年5月15日から2007年3月14日まで収集されました.
主要な成果:
- eGFRの報告は,慢性腎臓病 (CKD) の患者の腎臓科医への訪問の有意な増加と相関していました.
- 診察の増加は,EGFR <30 mL/min/1.73 m(2) の患者,女性,および高血圧や糖尿病などの併発性疾患を有する患者で特に顕著でした.
- eGFRの報告と全科医や内科医への訪問,あるいはCKD患者の特定の薬剤の使用との間には関連性が見つかりませんでした.
結論:
- eGFRの報告は,腎臓科医への紹介の増加と関連しており,特に腎臓病が進行している患者の場合は特にそうである.
- 特定の人口統計的および臨床的要因は,紹介後のeGFR報告の可能性に影響します.
- これらの腎臓科医の訪問の増加に関連する長期的な臨床結果については,さらなる調査が必要です.
関連する概念動画
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