ArticleBMJ evidence-based medicine2022
Kidney trajectory charts to assist general practitioners in the assessment of patients with reduced kidney function: a randomised vignette study.
Article in BMJ evidence-based medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- 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 · 2025Article
- Chronic kidney disease and the alternative labels used by GPs in Australia: a qualitative interview study.BJGP open · 2025Article
- General practitioners' assessment and management of chronic kidney disease in older patients- a mixed methods study.BMC primary care · 2024Article
- Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study.BJGP open · 2024Article
- Use of kidney trajectory charts as an adjunct to chronic kidney disease guidelines- a qualitative study of general practitioners.PloS one · 2024Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the decisional impact of an age-based chart of kidney function decline to support general practitioners (GPs) to appropriately interpret estimated glomerular filtration rate (eGFR) and identify patients with a clinically relevant kidney problem. DESIGN AND
settingRandomised vignette study
participants372 Australian GPs from August 2018 to November 2018.
interventionGPs were given two patient case scenarios: (1) an older woman with reduced but stable renal function and (2) a younger Aboriginal man with declining kidney function still in the normal range. One group was given an age-based chart of kidney function to assist their assessment of the patient (initial chart group); the second group was asked to assess the patients without the chart, and then again using the chart (delayed chart group).
main outcome measuresGPs' assessment of the likelihood-on a Likert scale-that the patients had chronic kidney disease (CKD) according to the usual definition or a clinical problem with their kidneys.
resultsPrior to viewing the age-based chart GPs were evenly distributed as to whether they thought case 1-the older woman-had CKD or a clinically relevant kidney problem. GPs who had initial access to the chart were less likely to think that the older woman had CKD, and less likely to think she had a clinically relevant problem with her kidneys than GPs who had not viewed the chart. After subsequently viewing the chart, 14% of GPs in the delayed chart group changed their opinion, to indicate she was unlikely to have a clinically relevant problem with her kidneys.Prior to viewing the chart, the majority of GPs (66%) thought case 2-the younger man-did not have CKD, and were evenly distributed as to whether they thought he had a clinically relevant kidney problem. In contrast, GPs who had initial access to the chart were more likely to think he had CKD and the majority (72%) thought he had a clinically relevant kidney problem. After subsequently viewing the chart, 37% of GPs in the delayed chart group changed their opinion to indicate he likely had a clinically relevant problem with his kidneys.
conclusionsUse of the chart changed GPs interpretation of eGFR, with increased recognition of the younger male patient's clinically relevant kidney problem, and increased numbers classifying the older female patient's kidney function as normal for her age. This study has shown the potential of an age-based kidney function chart to reduce both overdiagnosis and underdiagnosis.
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