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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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英国初级保健中的2型糖尿病慢性病:测试频率,编码精度和临床惯性
A Zafar1,2,3, C Scarlata1,3, N Jaleel4
1NIHR Leicestershire and Northamptonshire Commercial Research Delivery Centre, Leicester, UK.
Diabetic medicine : a journal of the British Diabetic Association
|February 12, 2026
概括
慢性病 (CKD) 编码和测试的差距存在于英国初级保健中2型糖尿病患者,特别是在农村地区和年轻人. 建议增加尿中的白蛋白-肌素比率 (uACR) 测试,并遵守指南.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 主要护理医学 医疗保健
背景情况:
- 慢性病 (CKD) 是2型糖尿病患者 (T2DM) 的常见并发症.
- 不充分的CKD监测和编码可能导致诊断延迟和管理不足.
- 临床惯性可能会导致T2DM患者的护理缺口,估计膜过率 (eGFR) 降低或尿中白蛋白-肌素比率 (uACR) 升高.
研究的目的:
- 发现英国初级保健中T2DM患者中CKD编码和测试方面的缺陷.
- 为了评估管理降低的eGFR和/或升高的uACR水平的临床惯性.
- 为了比较城市和农村初级保健机构之间的CKD监测实践.
主要方法:
- 来自SystmOne和PARM糖尿病工具的患者数据的回顾性横截面分析.
- 对T2DM患者进行查,至少有两例eGFR<60mL/min/1.73m2.
- 根据NICE指南对CKD编码准确性的评估.
主要成果:
- 城市和农村环境之间CKD监测和诊断的显著差异.
- 在12个月内,在77.3%的患者中记录了eGFR测试,在37.6%的患者中记录了uACR测试.
- 只有35%的人接受了这两种测试;在年轻的患者 (<60岁) 和晚期CKD患者中,吸收率最低.
- 61%的两个eGFR读数<60的患者仍未对CKD进行编码,而15%的患者读数更多.
结论:
- 在T2DM患者中,急需改进uACR测试和CKD编码.
- 临床惯性,受波动的eGFR/ACR水平和过程问题影响,影响CKD管理.
- 慢性结核病监测的缺陷不成比例地影响年轻患者和农村患者,需要审查编码实践和遵守指南.
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