Evidence map›Paper›PMID 20922494›Full record

ArticleJournal of general internal medicine2011

Primary care management of chronic kidney disease.

Adrienne S Allen, John P Forman, E John Orav, David W Bates, Bradley M Denker, Thomas D Sequist

Open access · bronzeAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 5 pooled it
2.5field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 5 syntheses or guidelines pooled it, 164 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Electronic Decision Support for Management of CKD in Primary Care: A Pragmatic Randomized Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020
    Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Impact of a Primary Care CKD Registry in a US Public Safety-Net Health Care Delivery System: A Pragmatic Randomized Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018
    Trial
  13. Trial
  14. Trial
  15. Article
  16. Review
  17. Prevalence of reduced eGFR in European adults using KDIGO and age-adapted eGFR thresholds.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
    Article
  18. Observational
  19. Article
  20. Article

39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Adrienne S AllenDivision of General Medicine, Brigham and Women's Hospital, Boston, MA, USA. aallen0@partners.org
John P Forman
E John Orav
David W Bates
Bradley M Denker
Thomas D Sequist
Brigham and Women's Hospital · US

Funding

A Risk Based Approach to Improving Management of Chronic Kidney DiseaseR18HS018226 · AHRQ · BRIGHAM AND WOMEN'S HOSPITAL · PI SEQUIST, THOMAS D · 2009 to 2011
$1.1M
AHRQ HHS R18 HS018226PHS HHS T32HP10251-02
6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) causes substantial morbidity and mortality; however, there are limited data to comprehensively assess quality of care in this area.

objectiveTo assess quality of care for CKD according to patient risk and identify correlates of improved care delivery.

designRetrospective cohort.

settingFifteen health centers within a multi-site group practice in eastern Massachusetts.

participants166 primary care physicians caring for 11,774 patients with stages 3 or 4 CKD defined as two estimated glomerular filtration rates (eGFR) between 15 and 60. MAIN MEASURES: Two measures of kidney disease monitoring, five measures of cardiovascular disease management, four measures of metabolic bone disease and anemia management, and one measure of drug safety were extracted from the electronic health record. Primary care recognition of CKD was assessed as a problem list diagnosis, and nephrology co-management was assessed as at least one visit with a nephrologist in the prior 12 months. KEY

resultsOverall, 46% of patients were high risk for death based on the presence of diabetes, proteinuria, or an eGFR <45. Seventy percent of patients lacked annual urine protein testing, 46% had a blood pressure ≥130/80 mmHg and 25% were not receiving appropriate angiotensin blockade. Appropriate screening for anemia was common (76%), while screening rates for metabolic bone disease were low. Use of potentially harmful drugs was common (26%). Primary care physician recognition and nephrology co-management were both associated with improved quality of care, though rates of both were low (24% and 10%, respectively).

conclusionsSignificant deficiencies in the quality of CKD care exist. Opportunities for improvement include increasing physician recognition of CKD and improving collaborative care with nephrology.

Indexed as

Physicians, Primary CareAgedAged, 80 and overCohort StudiesDisease ManagementFemaleGlomerular Filtration RateHumansKidney Failure, ChronicMaleMiddle AgedPrimary Health CareRetrospective Studies

Identifiers

PMID20922494
PMCPMC3055964
OpenAlexW1972972829

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.