Characteristics of patients with chronic kidney disease

Characteristics of patients with chronic kidney disease referred to a nephrology outpatient clinic: results of Nefrodata® study

ARTICOLI

ORIGINALI


Adamasco Cupisti1, Anna Bottai1, Vincenzo Bellizzi2, Giuliano Brunori3, † Bruno Cianciaruso4, Luca De Nicola5, Lamberto Oldrizzi6, Giuseppe Quintaliani7, Domenico Santoro8, Biagio Raffaele Di Iorio9 per NEFRODATA10 (1) Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa (2) Azienda Ospedaliera Universitaria “San Giovanni di Dio e Ruggi d’Aragona”, Salerno (3) S.C. Multizonale di Nefrologia e Dialisi Azienda Provinciale per i Servizi Sanitari P. O. “S.Chiara”, Trento (4) Cattedra di Nefrologia, Università degli Studi di Napoli “Federico II” (5) Seconda Università di Napoli, Struttura di Nefrologia e Dialisi, Napoli (6) U.O. di Nefrologia e Dialisi Ospedale “San Bonifacio”, Verona (7) S.C. di Nefrologia e Dialisi Ospedale Silvestrini, Perugia (8) UOC di Nefrologia e Dialisi, Policlinico Universitario “G. Martino”, Messina (9) U.O.C. di Nefrologia e Dialisi, P.O. “A. Landolfi”, Solofra (AV) (10) NefroData Study Group (in ordine alfabetico per città di provenienza): - Loreto Gesualdo, Dea Saulle (U.O.C. Di Dialisi e Trapianto Università di Bari A.O.U. Consorziale Policlinico di Bari) - Pietro Castellino, Pasquale Fatuzzo, Francesco Rapisarda (Dipartimento di Medicina, Policlinico Universitario, Catania) - Renzo Bonofiglio, Danilo Lofaro, Filomena Armentano (U.O.C. Nefrologia-Dialisi-Trapianto, Centro di Ricerca Rene e Trapianto AO “Annunziata” Cosenza) - Alberto Rosati, Giuseppina Rosso (U.O. Nefrologia e Dialisi, Ospedale San Luca, USL2 Lucca) - Stefano Chimienti (Manduria-TA) - Salvatore Coppola, Cesaro Antonio (U.O.S.D. Nefrologia e dialisi, P.O. Piedimonte Matese, Caserta) - Laura Bozzoli (Scuola di Specializzazione in Nefrologia, Università di Pisa) - Antonella De Blasio, Marilisa Sirico, Lucia Di Micco (Solofra, Avellino) Corrispondenza a: Dr. Biagio di Iorio; UOC di Nefrologia, Ospedale “A. Landolfi”, via Melito, 83029 Solofra (AV); Mail: [email protected]

Abstract Chronic kidney disease is acknowledged as one of the most relevant disease for public health. Knowledge of epidemiology of CKD may allow public health interventions both for prevention and treatment in order to limit burden and management costs. Nefrodata is a multicentric, prospective, and observational study conducted in Italy, including patients with CKD followed in a specialist setting. The study uses a web-based data setting; it includes 1263 subjects with an estimate glomerular filtration rate (eGFR) less than 60 ml/ min *1,73 sqm, followed in outpatient clinics in Italy. Patients' characteristics analysis evidences that old subjects (mean age of 70.3 ±13.4 years, 55% of them older than 70 years), with cardiovascular morbidity (50,6%) and diabetics (37%) have a high prevalence. With the reduction of residual renal function, prevalence of hyperphospatemia, metabolic acidosis, use of erythropoiesis-stimulating agents, Vitamin D, and diuretics increases. Also allopurinol and gastric-protective drugs are widely used. Fifty-four and eight % of patients with CKD stage 4 and 65.9% of patients with CKD stage 5 received indication on nutritional therapy. Key words: chronic kidney diseases, ckd, diet, epidemiology, therapy

G Ital Nefrol 2015; 32 (2) – ISSN 1724-5590 – © 2015 Società Italiana di Nefrologia

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Introduction Chronic kidney disease (CKD) is acknowledged as one of the most relevant disease for public health. Therefore, it is of paramount importance to know the incidence and the prevalence of the disease in our country, in order to allow public health interventions for primary and secondary prevention and for an adequate treatment. These interventions may delay progression toward dialysis, reduce morbidity, cardiovascular mortality and all disease-related costs. There are several studies reporting incidence and prevalence of CKD in Italy [1] [2] [3] [4]. Among them, the TABLE study conducted about 10 years ago and including patients with CKD stage 3-5 followed-up for at least one year by nephrologists, is a precious database to which compare data of our study [4]. A better knowledge of possible changes of CKD epidemiology in Italy in the last decade may allow an improved organization of diagnostic and therapeutic processes and of human and economic resources. More resources will be fundamental to evaluate the increase of social CKD-related costs with time and to implement therapy of advanced renal failure, and programs of secondary and tertiary prevention [5] (full text) [6]. The aim of the study is to understand and describe clinical characteristics of patients with CKD referred to Italian nephrologists and possible differences with already existing data.

Materials and Methods Nefrodata® is a multicentric, prospective and observational study conducted in Italy. We collected data of patients with chronic kidney disease referred to outpatients clinics specialized for kidney diseases. Inclusion criteria were age >18 years, estimated glomerular filtration rate (eGFR)