Estimated GFR reporting influences recommendations for dialysis initiation

Brimble, K. Scott, Mehrotra, Rajnish, Tonelli, Marcello, Hawley, Carmel M., Castledine, Clare, McDonald, Stephen P., Levidiotis, Vicki, Gangji, Azim S., Treleaven, Darin J., Margetts, Peter J. and Walsh, Michael (2013) Estimated GFR reporting influences recommendations for dialysis initiation. Journal of the American Society of Nephrology, 24 11: 1737-1742. doi:10.1681/ASN.2013010035

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Author Brimble, K. Scott
Mehrotra, Rajnish
Tonelli, Marcello
Hawley, Carmel M.
Castledine, Clare
McDonald, Stephen P.
Levidiotis, Vicki
Gangji, Azim S.
Treleaven, Darin J.
Margetts, Peter J.
Walsh, Michael
Title Estimated GFR reporting influences recommendations for dialysis initiation
Journal name Journal of the American Society of Nephrology   Check publisher's open access policy
ISSN 1046-6673
Publication date 2013-11-01
Year available 2013
Sub-type Article (original research)
DOI 10.1681/ASN.2013010035
Open Access Status DOI
Volume 24
Issue 11
Start page 1737
End page 1742
Total pages 6
Place of publication Washington, DC United States
Publisher American Society of Nephrology
Language eng
Formatted abstract
Automated reporting of estimated GFR (eGFR) with serum creatinine measurement is now common. We surveyed nephrologists in four countries to determine whether eGFR reporting influences nephrologists' recommendations for dialysis initiation. Respondents were randomly allocated to receive a survey of four clinical vignettes that included eitherserum creatinine concentration only orserum creatinine and the corresponding eGFR. For each scenario, the respondent was asked to rank his or her likelihood of recommending dialysis initiation on a modified 8-point Likert scale, ranging from 1 ("definitely not") to 8 ("definitely would"). Analysis of the 822 eligible responses received showed that the predicted likelihood of recommending dialysis increased by 0.55 points when eGFR was reported (95% confidence interval, 0.33 to 0.76), and this effect was larger for eGFRs > 5 ml/min per 1.73 m2 (P<0.001). Subgroup analyses suggested that physicians who had been in practice ≥13 years were more affected by eGFR reporting (P=0.03). These results indicate that eGFR reporting modestly increases the likelihood that dialysis is recommended, and physicians should be aware of this effect when assessing patients with severe CKD.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
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