ArticleBMC nephrology2015
Nephrology co-management versus primary care solo management for early chronic kidney disease: a retrospective cross-sectional analysis.
Article in BMC nephrology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Challenges and strategies for managing early-to-moderate chronic kidney disease in primary care: A systematic integrative review in high-income countries.The European journal of general practice · 2026Pooled it
- Quality of care for people with chronic kidney disease: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- 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 · 2020Trial
- A Microsimulation-Based Approach for Mitigating Societal Bias in Chronic Kidney Disease Data.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Care Processes and Clinical Responses to Newly Detected Albuminuria: The Stockholm Creatinine Measurements (SCREAM) Project.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Referral patterns in the CKD.QLD Registry: A call for revisiting the definition of late referral.PloS one · 2026Article
- A microsimulation-based framework for mitigating societal bias in primary care data.medRxiv : the preprint server for health sciences · 2025Article
- Patient Perceptions of a Population Health Management Program to Improve Kidney Care: Optimizing care in CKD.Kidney medicine · 2025Article
- Assessing patterns of chronic kidney disease care in Australian primary care: a retrospective cohort study of a national general practice dataset.The Lancet regional health. Western Pacific · 2025Article
- Obstacles and Opportunities for Albuminuria Testing On the Basis of the Perspective of Primary Care: A Qualitative Study.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Optimizing Prescribing for Individuals With Type 2 Diabetes and Chronic Kidney Disease Through the Development and Validation of Algorithms for Community Pharmacists.Canadian journal of kidney health and disease · 2025Article
- Article
- Primary and specialist care interaction and referral patterns for individuals with chronic kidney disease: a narrative review.BMC nephrology · 2024Review
- Review
- Electronic health record based population health management to optimize care in CKD: Design of the Kidney Coordinated HeAlth Management Partnership (K-CHAMP) trial.Contemporary clinical trials · 2023Article
- Albuminuria testing and nephrology care among insured US adults with chronic kidney disease: a missed opportunity.BMC primary care · 2022Article
- Impact of Kidney Failure Risk Prediction Clinical Decision Support on Monitoring and Referral in Primary Care Management of CKD: A Randomized Pragmatic Clinical Trial.Kidney medicine · 2022Article
- Multicomponent intervention to improve blood pressure management in chronic kidney disease: a protocol for a pragmatic clinical trial.BMJ open · 2021Article
- Importance of Early Screening and Diagnosis of Chronic Kidney Disease in Patients with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Review
- Referring patients with chronic kidney disease back to primary care: a criteria-based analysis in outpatient renal clinics.BMC nephrology · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPrimary care physicians (PCPs) typically manage early chronic kidney disease (CKD), but recent guidelines recommend nephrology co-management for some patients with stage 3 CKD and all patients with stage 4 CKD. We sought to compare quality of care for co-managed patients to solo managed patients.
methodsWe conducted a retrospective cross-sectional analysis. Patients included in the study were adults who visited a PCP during 2009 with laboratory evidence of CKD in the preceding two years, defined as two estimated glomerular filtration rates (eGFR) between 15-59 mL/min/1.73 m(2) separated by 90 days. We assessed process measures (serum eGFR test, urine protein/albumin test, angiotensin converting enzyme inhibitor or angiotensin receptor blocker [ACE/ARB] prescription, and several tests monitoring for complications) and intermediate clinical outcomes (mean blood pressure and blood pressure control) and performed subgroup analyses by CKD stage.
resultsOf 3118 patients, 11 % were co-managed by a nephrologist. Co-management was associated with younger age (69 vs. 74 years), male gender (46 % vs. 34 %), minority race/ethnicity (black 32 % vs. 22 %; Hispanic 13 % vs. 8 %), hypertension (75 % vs. 66 %), diabetes (42 % vs. 26 %), and more PCP visits (5.0 vs. 3.9; p < 0.001 for all comparisons). After adjustment, co-management was associated with serum eGFR test (98 % vs. 94 %, p = <0.0001), urine protein/albumin test (82 % vs 36 %, p < 0.0001), and ACE/ARB prescription (77 % vs. 69 %, p = 0.03). Co-management was associated with monitoring for anemia and metabolic bone disease, but was not associated with lipid monitoring, differences in mean blood pressure (133/69 mmHg vs. 131/70 mmHg, p > 0.50) or blood pressure control. A subgroup analysis of Stage 4 CKD patients did not show a significant association between co-management and ACE/ARB prescription (80 % vs. 73 %, p = 0.26).
conclusionFor stage 3 and 4 CKD patients, nephrology co-management was associated with increased stage-appropriate monitoring and ACE/ARB prescribing, but not improved blood pressure control.
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