Evidence map›Paper›PMID 28616249›Full record

ArticleCanadian journal of kidney health and disease2017

Quality of Care for Patients With Chronic Kidney Disease in the Primary Care Setting: A Retrospective Cohort Study From Ontario, Canada.

Danielle M Nash, Scott Brimble, Maureen Markle-Reid, Eric McArthur, Karen Tu, Gihad E Nesrallah, Allan Grill, Amit X Garg

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of kidney health and disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
18.5field-weighted citation impact, top 1% 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

22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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  20. Nonsteroidal anti-inflammatory drug use and risk of acute kidney injury and hyperkalemia in older adults: a population-based study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2019
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Danielle M NashInstitute for Clinical Evaluative Sciences Western, London, Ontario, Canada.
Scott BrimbleDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Maureen Markle-ReidDepartment of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Eric McArthurInstitute for Clinical Evaluative Sciences Western, London, Ontario, Canada.
Karen TuInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Gihad E NesrallahThe Ontario Renal Network, Toronto, Canada.
Allan GrillThe Ontario Renal Network, Toronto, Canada.
Amit X GargInstitute for Clinical Evaluative Sciences Western, London, Ontario, Canada.
Ontario Stroke Network · CAInstitute for Clinical Evaluative Sciences · CAMcMaster University · CASunnybrook Health Science Centre · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic kidney disease may not be receiving recommended primary renal care.

objectiveTo use recently established primary care quality indicators for chronic kidney disease to determine the proportion of patients receiving recommended renal care.

designRetrospective cohort study using administrative data with linked laboratory information.

settingThe study was conducted in Ontario, Canada, from 2006 to 2012. PATIENTS: Patients over 40 years with chronic kidney disease or abnormal kidney function in primary care were included. MEASUREMENTS: In total, 11 quality indicators were assessed for chronic kidney disease identified through a Delphi panel in areas of screening, monitoring, drug prescribing, and laboratory monitoring after initiating an angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB).

methodsWe calculated the proportion and cumulative incidence at the end of follow-up of patients meeting each indicator and stratified results by age, sex, cohort entry, and chronic kidney disease stage.

resultsLess than half of patients received follow-up tests after an initial abnormal kidney function result. Most patients with chronic kidney disease received regular monitoring of serum creatinine (91%), but urine albumin-to-creatinine monitoring was lower (70%). A total of 84% of patients age 66 and older did not receive a non-steroidal anti-inflammatory drug prescription of at least 2-week duration. Three quarters of patients age 66 and older were on an ACE inhibitor or ARB, and 96% did not receive an ACE inhibitor and ARB concurrently. Among patients 66 to 80 years of age with chronic kidney disease, 65% were on a statin. One quarter of patients age 66 and older who initiated an ACE inhibitor or ARB had their serum creatinine and potassium monitored within 7 to 30 days. LIMITATIONS: This study was limited to people in Ontario with linked laboratory information.

conclusionsThere was generally strong performance across many of the quality of care indicators. Areas where more attention may be needed are laboratory testing to confirm initial abnormal kidney function test results and monitoring serum creatinine and potassium after initiating a new ACE inhibitor or ARB.

Indexed as

care indicatorschronic kidney diseaseclinical guidelinesprimary carequality of care

Identifiers

PMID28616249
PMCPMC5461905
OpenAlexW2618043321

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.