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Clinical policies on the management of chronic kidney disease patients in Italy.
Nephrol Dial Transplant. 2008 Feb; 23(2):621-6.ND

Abstract

BACKGROUND

Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy.

METHODS

A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist.

RESULTS

Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases.

CONCLUSION

This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.

Authors+Show Affiliations

Department of Nephrology, Ospedale A. Manzoni, Lecco 23900, Italy. f.locatelli@ospedale.lecco.itNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18039648

Citation

Locatelli, Francesco, et al. "Clinical Policies On the Management of Chronic Kidney Disease Patients in Italy." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 2, 2008, pp. 621-6.
Locatelli F, Zoccali C, SIR SIN Study Investigators. Clinical policies on the management of chronic kidney disease patients in Italy. Nephrol Dial Transplant. 2008;23(2):621-6.
Locatelli, F., & Zoccali, C. (2008). Clinical policies on the management of chronic kidney disease patients in Italy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(2), 621-6.
Locatelli F, Zoccali C, SIR SIN Study Investigators. Clinical Policies On the Management of Chronic Kidney Disease Patients in Italy. Nephrol Dial Transplant. 2008;23(2):621-6. PubMed PMID: 18039648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical policies on the management of chronic kidney disease patients in Italy. AU - Locatelli,Francesco, AU - Zoccali,Carmine, AU - ,, Y1 - 2007/11/26/ PY - 2007/11/28/pubmed PY - 2008/7/17/medline PY - 2007/11/28/entrez SP - 621 EP - 6 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol. Dial. Transplant. VL - 23 IS - 2 N2 - BACKGROUND: Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy. METHODS: A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist. RESULTS: Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases. CONCLUSION: This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/18039648/Clinical_policies_on_the_management_of_chronic_kidney_disease_patients_in_Italy_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm636 DB - PRIME DP - Unbound Medicine ER -