Implementing a Formalized Risk-Based Approach to Determine Candidacy for Multidisciplinary CKD Care: A Descriptive Cohort Study
Background: The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting. Objective: Evaluate implementation of a formalized risk-based approach in nephrologists’ outpatient clinics and multidisciplinary chronic kidney disease (CKD) cli...
Saved in:
Published in | Canadian journal of kidney health and disease Vol. 10; p. 20543581231215865 |
---|---|
Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.01.2023
Sage Publications Ltd SAGE Publishing |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Background:
The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting.
Objective:
Evaluate implementation of a formalized risk-based approach in nephrologists’ outpatient clinics and multidisciplinary chronic kidney disease (CKD) clinics to determine candidacy for multidisciplinary care, and the impact of CKD care selection on clinical outcomes.
Design:
Population-based descriptive cohort study.
Setting:
Alberta Kidney Care South.
Patients:
Adults attending or considered for a multidisciplinary CKD clinic between April 1, 2017, and March 31, 2019.
Measurements:
Exposure—The course of CKD care assigned by the nephrologist: management at multidisciplinary CKD clinic; management by a nephrologist or primary care physician. Primary Outcome—CKD progression, defined as commencement of kidney replacement therapy (KRT). Secondary Outcomes—Death, emergency department visits, and hospitalizations.
Methods:
We linked operational data from the clinics (available until March 31, 2019) with administrative health and laboratory data (available until March 31, 2020). Comparisons among patient groups, courses of care, and clinical settings with negative binomial regression count models and calculated unadjusted and fully adjusted incidence rate ratios. For the all-cause death outcome, we used Cox survival models to calculate unadjusted and fully adjusted hazard ratios.
Results:
Of the 1748 patients for whom a KFRE was completed, 1347 (77%) remained in or were admitted to a multidisciplinary CKD clinic, 310 (18%) were managed by a nephrologist only, and 91 (5%) were referred back for management by their primary care physician. There was a much higher kidney failure risk among patients who remained at or were admitted to a multidisciplinary CKD clinic (median 2-year risk of 34.7% compared with 3.6% and 0.8% who remained with a nephrologist or primary care physician, respectively). None of the people managed by their primary care physician alone commenced KRT, while only 2 (0.6%) managed by a nephrologist without multidisciplinary CKD care commenced KRT. The rates of emergency department visits, hospitalizations, and death were lower in those assigned to management outside the multidisciplinary CKD clinics when compared with those managed in the multidisciplinary care setting.
Limitations:
The follow-up period may not have been long enough to determine outcomes, and potentially limited generalizability given variability of care in multidisciplinary clinics.
Conclusions:
Our findings indicate that a portion of patients can be directed to less resource-intensive care without a higher risk of adverse events.
Trial registration:
Not applicable. |
---|---|
AbstractList | Background: The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting. Objective: Evaluate implementation of a formalized risk-based approach in nephrologists’ outpatient clinics and multidisciplinary chronic kidney disease (CKD) clinics to determine candidacy for multidisciplinary care, and the impact of CKD care selection on clinical outcomes. Design: Population-based descriptive cohort study. Setting: Alberta Kidney Care South. Patients: Adults attending or considered for a multidisciplinary CKD clinic between April 1, 2017, and March 31, 2019. Measurements: Exposure—The course of CKD care assigned by the nephrologist: management at multidisciplinary CKD clinic; management by a nephrologist or primary care physician. Primary Outcome—CKD progression, defined as commencement of kidney replacement therapy (KRT). Secondary Outcomes—Death, emergency department visits, and hospitalizations. Methods: We linked operational data from the clinics (available until March 31, 2019) with administrative health and laboratory data (available until March 31, 2020). Comparisons among patient groups, courses of care, and clinical settings with negative binomial regression count models and calculated unadjusted and fully adjusted incidence rate ratios. For the all-cause death outcome, we used Cox survival models to calculate unadjusted and fully adjusted hazard ratios. Results: Of the 1748 patients for whom a KFRE was completed, 1347 (77%) remained in or were admitted to a multidisciplinary CKD clinic, 310 (18%) were managed by a nephrologist only, and 91 (5%) were referred back for management by their primary care physician. There was a much higher kidney failure risk among patients who remained at or were admitted to a multidisciplinary CKD clinic (median 2-year risk of 34.7% compared with 3.6% and 0.8% who remained with a nephrologist or primary care physician, respectively). None of the people managed by their primary care physician alone commenced KRT, while only 2 (0.6%) managed by a nephrologist without multidisciplinary CKD care commenced KRT. The rates of emergency department visits, hospitalizations, and death were lower in those assigned to management outside the multidisciplinary CKD clinics when compared with those managed in the multidisciplinary care setting. Limitations: The follow-up period may not have been long enough to determine outcomes, and potentially limited generalizability given variability of care in multidisciplinary clinics. Conclusions: Our findings indicate that a portion of patients can be directed to less resource-intensive care without a higher risk of adverse events. Trial registration: Not applicable. Background: The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting. Objective: Evaluate implementation of a formalized risk-based approach in nephrologists’ outpatient clinics and multidisciplinary chronic kidney disease (CKD) clinics to determine candidacy for multidisciplinary care, and the impact of CKD care selection on clinical outcomes. Design: Population-based descriptive cohort study. Setting: Alberta Kidney Care South. Patients: Adults attending or considered for a multidisciplinary CKD clinic between April 1, 2017, and March 31, 2019. Measurements: Exposure—The course of CKD care assigned by the nephrologist: management at multidisciplinary CKD clinic; management by a nephrologist or primary care physician. Primary Outcome—CKD progression, defined as commencement of kidney replacement therapy (KRT). Secondary Outcomes—Death, emergency department visits, and hospitalizations. Methods: We linked operational data from the clinics (available until March 31, 2019) with administrative health and laboratory data (available until March 31, 2020). Comparisons among patient groups, courses of care, and clinical settings with negative binomial regression count models and calculated unadjusted and fully adjusted incidence rate ratios. For the all-cause death outcome, we used Cox survival models to calculate unadjusted and fully adjusted hazard ratios. Results: Of the 1748 patients for whom a KFRE was completed, 1347 (77%) remained in or were admitted to a multidisciplinary CKD clinic, 310 (18%) were managed by a nephrologist only, and 91 (5%) were referred back for management by their primary care physician. There was a much higher kidney failure risk among patients who remained at or were admitted to a multidisciplinary CKD clinic (median 2-year risk of 34.7% compared with 3.6% and 0.8% who remained with a nephrologist or primary care physician, respectively). None of the people managed by their primary care physician alone commenced KRT, while only 2 (0.6%) managed by a nephrologist without multidisciplinary CKD care commenced KRT. The rates of emergency department visits, hospitalizations, and death were lower in those assigned to management outside the multidisciplinary CKD clinics when compared with those managed in the multidisciplinary care setting. Limitations: The follow-up period may not have been long enough to determine outcomes, and potentially limited generalizability given variability of care in multidisciplinary clinics. Conclusions: Our findings indicate that a portion of patients can be directed to less resource-intensive care without a higher risk of adverse events. Trial registration: Not applicable. BackgroundThe kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting.ObjectiveEvaluate implementation of a formalized risk-based approach in nephrologists' outpatient clinics and multidisciplinary chronic kidney disease (CKD) clinics to determine candidacy for multidisciplinary care, and the impact of CKD care selection on clinical outcomes.DesignPopulation-based descriptive cohort study.SettingAlberta Kidney Care South.PatientsAdults attending or considered for a multidisciplinary CKD clinic between April 1, 2017, and March 31, 2019.MeasurementsExposure-The course of CKD care assigned by the nephrologist: management at multidisciplinary CKD clinic; management by a nephrologist or primary care physician. Primary Outcome-CKD progression, defined as commencement of kidney replacement therapy (KRT). Secondary Outcomes-Death, emergency department visits, and hospitalizations.MethodsWe linked operational data from the clinics (available until March 31, 2019) with administrative health and laboratory data (available until March 31, 2020). Comparisons among patient groups, courses of care, and clinical settings with negative binomial regression count models and calculated unadjusted and fully adjusted incidence rate ratios. For the all-cause death outcome, we used Cox survival models to calculate unadjusted and fully adjusted hazard ratios.ResultsOf the 1748 patients for whom a KFRE was completed, 1347 (77%) remained in or were admitted to a multidisciplinary CKD clinic, 310 (18%) were managed by a nephrologist only, and 91 (5%) were referred back for management by their primary care physician. There was a much higher kidney failure risk among patients who remained at or were admitted to a multidisciplinary CKD clinic (median 2-year risk of 34.7% compared with 3.6% and 0.8% who remained with a nephrologist or primary care physician, respectively). None of the people managed by their primary care physician alone commenced KRT, while only 2 (0.6%) managed by a nephrologist without multidisciplinary CKD care commenced KRT. The rates of emergency department visits, hospitalizations, and death were lower in those assigned to management outside the multidisciplinary CKD clinics when compared with those managed in the multidisciplinary care setting.LimitationsThe follow-up period may not have been long enough to determine outcomes, and potentially limited generalizability given variability of care in multidisciplinary clinics.ConclusionsOur findings indicate that a portion of patients can be directed to less resource-intensive care without a higher risk of adverse events.Trial registrationNot applicable. |
Author | Manns, Braden J. Donald, Maoliosa Tonelli, Marcello Weaver, Robert G. Smekal, Michelle Harrison, Tyrone G. Tangri, Navdeep Thomas, Chandra Quinn, Robert R. Bello, Aminu Hemmelgarn, Brenda R. |
AuthorAffiliation | 4 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada 5 Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada 1 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada 3 Department of Medicine, University of Alberta, Edmonton, Canada 2 Department of Medicine, Cumming School of Medicine, University of Calgary, AB, Canada 6 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada |
AuthorAffiliation_xml | – name: 1 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, AB, Canada – name: 3 Department of Medicine, University of Alberta, Edmonton, Canada – name: 2 Department of Medicine, Cumming School of Medicine, University of Calgary, AB, Canada – name: 6 Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada – name: 5 Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada – name: 4 Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada |
Author_xml | – sequence: 1 givenname: Maoliosa surname: Donald fullname: Donald, Maoliosa – sequence: 2 givenname: Robert G. orcidid: 0000-0002-8403-857X surname: Weaver fullname: Weaver, Robert G. – sequence: 3 givenname: Michelle orcidid: 0000-0003-0960-3628 surname: Smekal fullname: Smekal, Michelle – sequence: 4 givenname: Chandra surname: Thomas fullname: Thomas, Chandra – sequence: 5 givenname: Robert R. surname: Quinn fullname: Quinn, Robert R. – sequence: 6 givenname: Braden J. orcidid: 0000-0002-8823-6127 surname: Manns fullname: Manns, Braden J. – sequence: 7 givenname: Marcello surname: Tonelli fullname: Tonelli, Marcello – sequence: 8 givenname: Aminu surname: Bello fullname: Bello, Aminu – sequence: 9 givenname: Tyrone G. orcidid: 0000-0003-1068-8673 surname: Harrison fullname: Harrison, Tyrone G. – sequence: 10 givenname: Navdeep orcidid: 0000-0002-5075-6370 surname: Tangri fullname: Tangri, Navdeep – sequence: 11 givenname: Brenda R. surname: Hemmelgarn fullname: Hemmelgarn, Brenda R. email: brenda.hemmelgarn@ahs.ca |
BookMark | eNp1kktv1DAUhSNUJErpD2BniQ2bKX7Ej7BBw5TCiCIk6N66sZ0ZD0kcbKfSsOGv42EqoCBWvjo-5_O9V35cnYxhdFX1lOALQqR8QTGvGVeEMkIJV4I_qE4P2uIgnvxRP6rOU9phjAnlXDbktPq-HqbeDW7MftwgQFchDtD7b86iTz59WbyGVMrlNMUAZotyQJcuuzj40aEVjNZbMHvUhYg-zH321ifjp96PEPdo9f6yeKJ7iZYllUz0U_a3JRe2IWb0Oc92_6R62EGf3PndeVbdXL25Wb1bXH98u14trxemFjQvWkVkA8CMaiQF51qqOiak5IZIYtuaEQEdFxyY5Vy1zvKurYVoRdFUg9lZtT5ibYCdnqIfSoM6gNc_hRA3GmL2pneaCS5b3gGxjtcdKMVrSg0uTxiqbMcL69WRNc3t4Kwpu4vQ34Pevxn9Vm_CrSZYNIxSUgjP7wgxfJ1dynooe3N9D6MLc9K0TFkryUVdrM_-su7CHMeyKk0bikmZTbHiIkeXiSGl6Lpf3RCsD19E__NFSubimEmwcb-p_w_8AGtrvQs |
Cites_doi | 10.1016/j.ekir.2021.05.031 10.2215/CJN.00100107 10.1177/2054358118763809 10.1038/kisup.2012.1 10.1093/ndt/gfx067. 10.1053/j.ajkd.2016.07.030. 10.1177/20543581177227. 10.1186/s12911-015-0155-5. 10.1053/j.ajkd.2021.06.028. 10.1177/2054358119882667. 10.1681/ASN.2019060605. 10.1177/205435811770537. 10.1371/journal.pmed.1002532. 10.1371/journal.pmed.1002955 10.1177/1129729818786630. 10.1186/1471-2369-10-30. 10.1097/MNH.0b013e328359072f. 10.1371/journal.pmed.1002128. 10.1177/2054358117753618. 10.1001/jama.2011.451. 10.1016/S0140-6736(20)30045-3. 10.1056/NEJMoa041031. 10.7326/0003-4819-150-9-200905050-00006. 10.2215/CJN.12391211. 10.1177/20543581221118434 |
ContentType | Journal Article |
Copyright | The Author(s) 2023 The Author(s) 2023. This work is licensed under the Creative Commons Attribution License https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. The Author(s) 2023 2023 Canadian Society of Nephrology, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses |
Copyright_xml | – notice: The Author(s) 2023 – notice: The Author(s) 2023. This work is licensed under the Creative Commons Attribution License https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: The Author(s) 2023 2023 Canadian Society of Nephrology, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses |
DBID | AFRWT AAYXX CITATION 3V. 7X7 7XB 88C 8FI 8FJ 8FK 8FQ 8FV ABUWG AFKRA AZQEC BENPR CCPQU DWQXO FYUFA GHDGH K9. M0S M0T PIMPY PQEST PQQKQ PQUKI PRINS Q9U 7X8 5PM DOA |
DOI | 10.1177/20543581231215865 |
DatabaseName | Sage Journals GOLD Open Access 2024 CrossRef ProQuest Central (Corporate) Health & Medical Collection ProQuest Central (purchase pre-March 2016) Healthcare Administration Database (Alumni) Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) Canadian Business & Current Affairs Database Canadian Business & Current Affairs Database (Alumni Edition) ProQuest Central (Alumni Edition) ProQuest Central ProQuest Central Essentials ProQuest Central ProQuest One Community College ProQuest Central Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Health & Medical Complete (Alumni) Health & Medical Collection (Alumni Edition) Health Management Database (Proquest) Publicly Available Content Database ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic ProQuest One Academic UKI Edition ProQuest Central China ProQuest Central Basic MEDLINE - Academic PubMed Central (Full Participant titles) Directory of Open Access Journals |
DatabaseTitle | CrossRef Publicly Available Content Database ProQuest Central Basic ProQuest Central Essentials ProQuest One Academic Eastern Edition ProQuest Health & Medical Complete (Alumni) ProQuest Health Management ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Central China ProQuest Hospital Collection (Alumni) ProQuest Central CBCA Complete (Alumni Edition) ProQuest Health & Medical Complete Health Research Premium Collection ProQuest One Academic UKI Edition Health and Medicine Complete (Alumni Edition) ProQuest Central Korea ProQuest Health Management (Alumni Edition) CBCA Complete ProQuest One Academic ProQuest Central (Alumni) MEDLINE - Academic |
DatabaseTitleList | Publicly Available Content Database CrossRef MEDLINE - Academic |
Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: AFRWT name: SAGE Open Access url: http://journals.sagepub.com/ sourceTypes: Publisher – sequence: 3 dbid: BENPR name: AUTh Library subscriptions: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 2054-3581 |
EndPage | 20543581231215865 |
ExternalDocumentID | oai_doaj_org_article_3657b5fa1de54fa885422c0431c28df5 10_1177_20543581231215865 10.1177_20543581231215865 |
GrantInformation_xml | – fundername: Canadian Institutes of Health Research grantid: FDN - 148433 funderid: https://doi.org/10.13039/501100000024 – fundername: ; grantid: FDN - 148433 |
GroupedDBID | 0R~ 31X 3V. 54M 5VS 7X7 8FI 8FJ 8FQ AATBZ ABQXT ABUWG ABVFX ACARO ACGFS ACGZU ACRMQ ACROE ACSIQ ADBBV ADINQ ADOGD ADPDF ADRAZ ADUKV AEWDL AEWHI AFCOW AFGXO AFKRA AFKRG AFRWT AHBYD AHSBF AHYZX AIOMO AJUZI ALIPV ALMA_UNASSIGNED_HOLDINGS AMKLP AOIJS AQUVI ASPBG AUTPY AYAKG BAWUL BCNDV BDDNI BENPR BFQNJ BMC BPHCQ BSEHC BVXVI C24 C6C CCPQU DC. DIK DV7 DWQXO EBS EJD EMOBN FYUFA GROUPED_DOAJ GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION HMCUK HYE J8X K.F KQ8 M0T M48 M~E O9- OK1 OVD OVEED PIMPY PQQKQ PROAC ROL RPM RSV SFC SFK SFT SGV SOJ SPP TEORI UKHRP AAYXX CITATION H13 PGMZT 7XB 8FK AZQEC K9. PQEST PQUKI PRINS Q9U 7X8 5PM |
ID | FETCH-LOGICAL-c462t-b8179aa3c8972aeeb28f36775c171db4316af565a3d558bed5fb466b65658903 |
IEDL.DBID | RPM |
ISSN | 2054-3581 |
IngestDate | Thu Jul 04 20:57:53 EDT 2024 Tue Sep 17 21:29:58 EDT 2024 Fri Aug 16 21:15:47 EDT 2024 Fri Sep 13 00:30:47 EDT 2024 Thu Sep 12 17:01:09 EDT 2024 Tue Jul 16 20:51:36 EDT 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Keywords | kidney failure nondialysis care chronic kidney disease kidney failure risk |
Language | English |
License | This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c462t-b8179aa3c8972aeeb28f36775c171db4316af565a3d558bed5fb466b65658903 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ORCID | 0000-0002-5075-6370 0000-0002-8823-6127 0000-0003-1068-8673 0000-0003-0960-3628 0000-0002-8403-857X |
OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693221/ |
PQID | 2920190383 |
PQPubID | 2040156 |
ParticipantIDs | doaj_primary_oai_doaj_org_article_3657b5fa1de54fa885422c0431c28df5 pubmedcentral_primary_oai_pubmedcentral_nih_gov_10693221 proquest_miscellaneous_2897487564 proquest_journals_2920190383 crossref_primary_10_1177_20543581231215865 sage_journals_10_1177_20543581231215865 |
PublicationCentury | 2000 |
PublicationDate | 2023-01-01 |
PublicationDateYYYYMMDD | 2023-01-01 |
PublicationDate_xml | – month: 01 year: 2023 text: 2023-01-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | Los Angeles, CA |
PublicationPlace_xml | – name: Los Angeles, CA – name: London – name: Sage CA: Los Angeles, CA |
PublicationTitle | Canadian journal of kidney health and disease |
PublicationYear | 2023 |
Publisher | SAGE Publications Sage Publications Ltd SAGE Publishing |
Publisher_xml | – name: SAGE Publications – name: Sage Publications Ltd – name: SAGE Publishing |
References | Che, Iliescu, Thanabalasingam, Day, White 2022; 9 Rigatto, Sood, Tangri 2012; 21 Hingwala, Wojciechowski, Hiebert 2017; 4 Duggal, Montez-Rath, Thomas 2022; 79 Tonelli, Wiebe, Fortin 2016; 15 Hemmelgarn, Smekal, Weaver 2018; 5 Major, Shepherd, Medcalf 2019; 16 Blantz 2007; 2 Inston, Lok 2019; 20 Shardlow, McIntyre, Fluck, McIntyre, Taal 2016; 13 Collister, Pyne, Cunningham 2019; 6 2012; 2 Lin, Chertow, Yan 2018; 15 Bhachu, Cockwell, Subramanian 2021; 6 Manns, Tonelli, Culleton 2012; 7 Tangri, Stevens, Griffith 2011; 305 Levey, Stevens, Schmid 2009; 150 Tangri, Ferguson, Komenda 2017; 32 Go, Chertow, Fan 2004; 351 Smekal, Tam-Tham, Finlay 2018; 5 Hemmelgarn, Clement, Manns 2009; 10 Weaver, James, Ravani 2020; 31 Tangri, Inker, Hiebert 2017; 69 Bikbov, Purcell, Levey 2020; 395 Whitlock, Chartier, Komenda 2017; 4 bibr6-20543581231215865 McAlister FA (bibr13-20543581231215865) 2011 bibr9-20543581231215865 bibr19-20543581231215865 bibr16-20543581231215865 bibr20-20543581231215865 bibr10-20543581231215865 KDIGO Work Group (bibr3-20543581231215865) 2012; 2 bibr23-20543581231215865 bibr26-20543581231215865 Government of Alberta (bibr18-20543581231215865) 2022 bibr25-20543581231215865 bibr12-20543581231215865 bibr15-20543581231215865 bibr22-20543581231215865 bibr2-20543581231215865 bibr5-20543581231215865 bibr8-20543581231215865 bibr28-20543581231215865 Kidney Strategic Clinical Network (bibr14-20543581231215865) 2015 bibr17-20543581231215865 bibr27-20543581231215865 bibr11-20543581231215865 bibr24-20543581231215865 bibr7-20543581231215865 bibr1-20543581231215865 bibr4-20543581231215865 bibr21-20543581231215865 |
References_xml | – volume: 395 start-page: 709 year: 2020 end-page: 733 article-title: Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 publication-title: Lancet contributor: fullname: Levey – volume: 9 start-page: 20543581221118434 year: 2022 article-title: Death and dialysis following discharge from chronic kidney disease clinic: a retrospective cohort study publication-title: Can J Kidney Health Dis contributor: fullname: White – volume: 4 start-page: 2054358117722782 year: 2017 article-title: Risk-based triage for nephrology referrals using the kidney failure risk equation publication-title: Can J Kidney Health Dis contributor: fullname: Hiebert – volume: 5 start-page: 2054358117753618 year: 2018 article-title: Implementation and evaluation of a risk-based approach to guide chronic kidney disease care: protocol for a multiphase mixed-methods study publication-title: Can J Kidney Health Dis contributor: fullname: Weaver – volume: 79 start-page: 347 year: 2022 end-page: 353 article-title: Nephrology referral based on laboratory values, kidney failure risk, or both: a study using veterans affairs health system data publication-title: Am J Kidney Dis contributor: fullname: Thomas – volume: 69 start-page: 514 issue: 4 year: 2017 end-page: 520 article-title: A dynamic predictive model for progression of CKD publication-title: Am J Kidney Dis contributor: fullname: Hiebert – volume: 305 start-page: 1553 year: 2011 end-page: 1559 article-title: A predictive model for progression of chronic kidney disease to kidney failure publication-title: JAMA contributor: fullname: Griffith – volume: 5 start-page: 2054358118763809 year: 2018 article-title: Perceived benefits and challenges of a risk-based approach to multidisciplinary chronic kidney disease care: a qualitative descriptive study publication-title: Can J Kidney Health Dis contributor: fullname: Finlay – volume: 150 start-page: 604 year: 2009 end-page: 612 article-title: A new equation to estimate glomerular filtration rate publication-title: Ann Intern Med contributor: fullname: Schmid – volume: 10 start-page: 1 year: 2009 end-page: 7 article-title: Overview of the Alberta kidney disease network publication-title: BMC Nephrol contributor: fullname: Manns – volume: 21 start-page: 612 issue: 6 year: 2012 end-page: 618 article-title: Risk prediction in chronic kidney disease: pitfalls and caveats publication-title: Curr Opin Nephrol Hypertens contributor: fullname: Tangri – volume: 32 start-page: 748 year: 2017 end-page: 751 article-title: Pro: risk scores for chronic kidney disease progression are robust, powerful and ready for implementation publication-title: Nephrol Dial Transplant contributor: fullname: Komenda – volume: 31 start-page: 591 issue: 3 year: 2020 end-page: 601 article-title: Estimating urine albumin-to-creatinine ratio from protein-to-creatinine ratio: development of equations using same-day measurements publication-title: J Am Soc Nephrol contributor: fullname: Ravani – volume: 4 start-page: 2054358117705372 year: 2017 article-title: Validation of the kidney failure risk equation in Manitoba publication-title: Can J Kidney Health Dis contributor: fullname: Komenda – volume: 7 start-page: 565 issue: 4 year: 2012 end-page: 572 article-title: A cluster randomized trial of an enhanced eGFR prompt in chronic kidney disease publication-title: Clin J Am Soc Nephrol contributor: fullname: Culleton – volume: 6 start-page: 2054358119882667 year: 2019 article-title: Multidisciplinary chronic kidney disease clinic practices: a scoping review publication-title: Can J Kidney Health Dis contributor: fullname: Cunningham – volume: 16 year: 2019 article-title: The kidney failure risk equation for prediction of end stage renal disease in UK primary care: an external validation and clinical impact projection cohort study publication-title: PLoS Med contributor: fullname: Medcalf – volume: 351 start-page: 1296 year: 2004 end-page: 1305 article-title: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization publication-title: N Engl J Med contributor: fullname: Fan – volume: 6 start-page: 2189 issue: 8 year: 2021 end-page: 2199 article-title: Impact of using risk-based stratification on referral of patients with chronic kidney disease from primary care to specialist care in the United Kingdom publication-title: Kidney Int Rep contributor: fullname: Subramanian – volume: 15 year: 2018 article-title: Cost-effectiveness of multidisciplinary care in mild to moderate chronic kidney disease in the United States: a modeling study publication-title: PLoS Med contributor: fullname: Yan – volume: 20 start-page: 95 issue: 1 year: 2019 end-page: 97 article-title: Improving precision in prediction: using kidney failure risk equations as a potential adjunct to vascular access planning publication-title: J Vasc Access contributor: fullname: Lok – volume: 15 start-page: 1 year: 2016 end-page: 11 article-title: Methods for identifying 30 chronic conditions: application to administrative data publication-title: BMC Med Inform Decis Mak contributor: fullname: Fortin – volume: 2 start-page: 193 issue: 2 year: 2007 end-page: 195 article-title: Handing out grades for care in chronic kidney disease: nephrologists versus non-nephrologists publication-title: Clin J Am Soc Nephrol contributor: fullname: Blantz – volume: 2 start-page: 1 year: 2012 end-page: 138 article-title: KDIGO clinical practice guideline for acute kidney injury publication-title: Kidney Int Suppl – volume: 13 issue: 9 year: 2016 article-title: Chronic kidney disease in primary care: outcomes after five years in a prospective cohort study publication-title: PLoS Med contributor: fullname: Taal – volume-title: Quality of Care in Early Stage Chronic Kidney Disease: 2012-2013: Supplementary Report to the 2015 Alberta Annual Kidney Care Report year: 2015 ident: bibr14-20543581231215865 contributor: fullname: Kidney Strategic Clinical Network – volume-title: The End of the Risk–Treatment Paradox? a Rising Tide Lifts All Boats year: 2011 ident: bibr13-20543581231215865 contributor: fullname: McAlister FA – ident: bibr25-20543581231215865 doi: 10.1016/j.ekir.2021.05.031 – ident: bibr26-20543581231215865 doi: 10.2215/CJN.00100107 – ident: bibr16-20543581231215865 doi: 10.1177/2054358118763809 – volume: 2 start-page: 1 year: 2012 ident: bibr3-20543581231215865 publication-title: Kidney Int Suppl doi: 10.1038/kisup.2012.1 contributor: fullname: KDIGO Work Group – ident: bibr7-20543581231215865 doi: 10.1093/ndt/gfx067. – ident: bibr8-20543581231215865 doi: 10.1053/j.ajkd.2016.07.030. – ident: bibr6-20543581231215865 doi: 10.1177/20543581177227. – ident: bibr21-20543581231215865 doi: 10.1186/s12911-015-0155-5. – ident: bibr27-20543581231215865 doi: 10.1053/j.ajkd.2021.06.028. – ident: bibr12-20543581231215865 doi: 10.1177/2054358119882667. – ident: bibr20-20543581231215865 doi: 10.1681/ASN.2019060605. – ident: bibr9-20543581231215865 doi: 10.1177/205435811770537. – ident: bibr11-20543581231215865 doi: 10.1371/journal.pmed.1002532. – ident: bibr24-20543581231215865 doi: 10.1371/journal.pmed.1002955 – ident: bibr22-20543581231215865 doi: 10.1177/1129729818786630. – ident: bibr17-20543581231215865 doi: 10.1186/1471-2369-10-30. – ident: bibr4-20543581231215865 doi: 10.1097/MNH.0b013e328359072f. – ident: bibr23-20543581231215865 doi: 10.1371/journal.pmed.1002128. – ident: bibr15-20543581231215865 doi: 10.1177/2054358117753618. – volume-title: Interactive Health Data Application year: 2022 ident: bibr18-20543581231215865 contributor: fullname: Government of Alberta – ident: bibr5-20543581231215865 doi: 10.1001/jama.2011.451. – ident: bibr1-20543581231215865 doi: 10.1016/S0140-6736(20)30045-3. – ident: bibr2-20543581231215865 doi: 10.1056/NEJMoa041031. – ident: bibr19-20543581231215865 doi: 10.7326/0003-4819-150-9-200905050-00006. – ident: bibr10-20543581231215865 doi: 10.2215/CJN.12391211. – ident: bibr28-20543581231215865 doi: 10.1177/20543581221118434 |
SSID | ssj0001255791 |
Score | 2.2590842 |
Snippet | Background:
The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting.
Objective:
Evaluate... Background: The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting. Objective: Evaluate... BackgroundThe kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting.ObjectiveEvaluate... |
SourceID | doaj pubmedcentral proquest crossref sage |
SourceType | Open Website Open Access Repository Aggregation Database Publisher |
StartPage | 20543581231215865 |
SubjectTerms | Clinics Cohort analysis Emergency medical care Kidney diseases Original Clinical Research Quantitative Primary care |
SummonAdditionalLinks | – databaseName: Directory of Open Access Journals dbid: DOA link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3fS-QwEB7EB_FFTj2xnkoE4eCgaNImzfq2u94iJ_pwKPhW8qu6eHSPcxXWF_91Z9qo3ZPDl3tsk9Amk8l8k8x8AdjX6rCwymWpc5UkUu0iNaHqpV54h8ufDy0D39m5OrnMf1zJq85VXxQT1tIDtwN3kClZWFkZ7oPMK6O1zIVwRAnjhPZVy17KZceZandXpCx6PB5jEsOSQGxCXF-IZ9DKaTImHUPU8PXPgcy_QyQ7cV6N6Rl9gpWIGVm__ddVWAj1GiydxVPxdXhqKH6buJ_6mhk2Ihz6a_wYPPs5vrtNB2ipPOtH9nA2nbDjGAQT2JDSWrxxM4bolTXpuN1EXTY8PWaUo3TE-tgqrjEP2G5yg8CdURji7DNcjL5fDE_SeLFC6nIlpqnVqIbGZE73CmECOte6ylRRSMcL7i1lx5sKkZ7JvJTaBi8rmytlEftJ3TvMNmCxntRhExjqbEAh2MwSNBGo_VxapwI3-Cy1T-DbyyCXv1v6jJJHhvF3EklgQGJ4rUjM180LnA9lnA_lR_Mhge0XIZZRHe9KupILkQ964wnsvRajItHpiKnD5B7r4GCQ96byBPSc8Od-aL6kHt80lNzoWCMQFjyBrzRP3r78z85u_Y_OfoFlgaCr3RLahsXpn_uwgyBpancbfXgGHAELdg priority: 102 providerName: Directory of Open Access Journals – databaseName: ProQuest Central dbid: BENPR link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV1Za9wwEB7SBEpfQk_qXKhQKBTMVrIla_NSdjdZlpaEElLIm9HlZEmwcziB5KV_vTNebbLb0j76wrJHM_NJM_MNwEetvhRWuSx1rpJEql2kJlT91Avv0Pz5MGPgOzhUk5_5txN5sgKTeS0MpVXObWJnqH3jaI-8R12V0HnhgqpnLO0CuLb39fIqpf5RFGeNzTSewZrgOQVs14b7hz-OFvZbpCz6PAY2iXNJIFoh9i9EOOj3NLmXBdfUMfgvwc4_kyYXMr86ZzR-CesRRbLBTOyvYCXUr-H5QYyTv4FfHelvlwlUnzLDxoRML6YPwbOj6c15OkTf5dkg8omztmF7MS0msBEVunjj7hniWdYV6C6W7rLR9z1GVUu7bIBPRatzh881ZwjlGSUm3r-F4_H-8WiSxlYLqcuVaFOrUTGNyZzuF8IEXG7rKlNFIR0vuLdUL28qxH4m81JqG7ysbK6URTQoNUrlHazWTR3eA0MtDr6SNrMEVgTaAy6tU4EbPJbaJ_B5_pPLyxmhRskj5_hfEklgSGJ4vJG4sLsTzfVpGVWrzJQsrKwM90HmldFa5kI4Ig1yQuNQEtiaC7GMCnpTPk2nBD48XkbVoniJqUNzi_fgz6D1nMoT0EvCXxrQ8pV6etaRdONSG6Gx4Al8onny9OZ_fuzG_8e5CS-o1f1s-2cLVtvr27CNgKi1O3Gu_wY6KAhU priority: 102 providerName: ProQuest – databaseName: Sage Journals GOLD Open Access 2024 dbid: AFRWT link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV1Lb9QwEB6VVkJcEE8RKMhISEhIhsaJHS-37ZZVBSqHahG9RX6lXZUmqM0iLRf-OjOJUzY8JI5xHNnxeOxvPDOfAV5otVdY5TLuXCWJVLvgJlQT7oV3uPz50DPwHX1Uh5_y9yfyZAuaIRcmjuDVawqrwh51izVpN51Gv4lORrTYZU7EXQhOcMvSCk369qLsj7uHWzWohPzTqwtybTsKiFzzIb3tBuwINP5QJXam8-PPi41jGSmL7p49aoNTI9EX-td2R7tZR_o_Qqq_x1luBIt1-9f8DtyOwJNN-5lyF7ZCfQ9uHkXX-n340fEEd8FD9SkzbE5g9svye_DseHl1zvdxu_NsGinIWduwgxhJE9iMcmO8cWuGEJh1Ob2b2b5s9uGAUaLTWzbFr-JC9Q2_a84Q_TOKZVw_gMX83WJ2yOPtDNzlSrTcatRlYzKnJ4UwAS10XWWqKKRLi9RbSrE3FcJFk3kptQ1eVjZXyiKAlHqylz2E7bqpwyNgqPjBV9JmlvANyqVIpXUqpAafpfYJvBoGufzac3CUaaQp_0MiCeyTGK4rEn12V9BcnpZRG8tMycLKyqQ-yLwyWstcCEc8Q05o7EoCu4MQy2FGlnSvF8InNOkTeH79GrWRXCymDs0K6-BgkAmo8gT0SPijDo3f1MuzjtcbrXNE0yJN4CXNk18t__NnH_93zSdwSyA86w-PdmG7vVyFpwinWvssqsBPdEgYtg priority: 102 providerName: SAGE Publications – databaseName: Scholars Portal Open Access Journals dbid: M48 link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV3daxQxEB9qBfFF_MS1VSIIgrDSzSbZnCByvXoU5XyQFvq25Gvbw7Jrr1fxfPFfdyabq12t4OPuJrvZZCb5TTLzG4AXWu1UVrkyd66RRKpd5SY0o9xz73D686Fn4Jt9UvuH4sORPNqAdXqr1IHn15p2lE_qcHH6-vvZ6h0q_Nt05Ij2uxRE44VQBRcwreQNuMlFKUjgZwnt91suUlYxhx7VyKlKOue89i2DlSoS-g9Q6J8-lFccweLaNL0LdxKoZONeCu7BRmjvw61ZOjZ_AD8jB3B0DGqPmWFTAqqn8x_Bs8_z8y_5Li5lno0TvThbdmwveckENqG4F2_ciiG8ZTFe92okL5t83GMUxPSGjbFWmoS-Yb3uBDuVkZ_i6iEcTN8fTPbzlHkhd0LxZW416qkxpdOjipuA1rduSlVV0hVV4S2Fz5sGoaApvZTaBi8bK5SyCA6lHu2Uj2Cz7drwGBgqdfCNtKUl7MJxeiikdSoUBq-l9hm8Wndy_bXn16iLREH-14hksEvDcFmQqLHjjW5xXCdNq0slKysbU_ggRWO0loJzRxxCjmtsSgbb60Gs1-JWU84uhEZormfw_PIxahodn5g2dBdYBjuDzDslMtCDwR80aPiknZ9Ezm60vBEp8yKDlyQnv7_8z5998h8N2YLbHEFXvyW0DZvLxUV4iiBpaZ9F0f8F9-UKCw priority: 102 providerName: Scholars Portal |
Title | Implementing a Formalized Risk-Based Approach to Determine Candidacy for Multidisciplinary CKD Care: A Descriptive Cohort Study |
URI | https://journals.sagepub.com/doi/full/10.1177/20543581231215865 https://www.proquest.com/docview/2920190383/abstract/ https://search.proquest.com/docview/2897487564 https://pubmed.ncbi.nlm.nih.gov/PMC10693221 https://doaj.org/article/3657b5fa1de54fa885422c0431c28df5 |
Volume | 10 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3da9swED_aDsZexj6Zty5oMBgM3NSy9ZG9JWlD2UgpIWN5M_pyG9rapU0H3cv-9Z1kuUs29rIXG1s2knU63--ku58A3ku-LzQ3eWpMxTyptkiVqwappdbg78-6loFvesyPvhafF2yxBbzLhQlB-0Yv9-qLy716eRZiK68uTb-LE-ufTMfoxiDsoFl_G7ZFnq_56O3MCmNikMUlTM-uRBGXeJ4vxDJo4aQ3JGtGKHD1bwDMP8Mj12K8gtmZPIHHES-SYduup7Dl6mfwcBpXxJ_Dz0DvG2J-6lOiyMRj0IvlD2fJbHlzno7QSlkyjMzhZNWQgxgA48jYp7RYZe4IIlcSUnHXk3TJ-MsB8flJn8gQ34r_l-_4XnOGoJ34EMS7FzCfHM7HR2ncVCE1BaerVEtUQaVyIweCKoeOtaxyLgQzmcis9pnxqkKUp3LLmNTOskoXnGvEfUwO9vOXsFM3tXsFBPXV2YrpXHtYQlHzM6YNd5nCayZtAh-7Ti6vWuqMMovs4n9JJIGRF8P9g571Otxork_LKPsy50xoVqnMOlZUSkpWUGo8PZChEpuSwG4nxDKq4k3pt-NC1IOeeALv7otRifzKiKpdc4vPYGd4z40XCcgN4W80aLMER2eg4-5GYwIf_Dj5XfM_P_b1_1fyBh75De_bSaBd2Fld37q3CItWuoe6sBA9eDCczL7N8Tw6PD6Z9cIkAx6nhewFPfkFhcAQzg |
link.rule.ids | 230,315,733,786,790,870,891,2115,12083,21416,21994,24346,27886,27957,27958,31754,31755,33779,33780,43345,43840,44980,45368,53827,53829 |
linkProvider | National Library of Medicine |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3db9MwED_BkIAXxKeWbYCRkJCQIogTf5QX1HVUha17QEXqW-SvbBUoGWuHNF7417lz3a0FwWPiWHFyvruf7bvfAbzU8q2y0pW5c40gUm2Vm9D0cs-9Q_Pnw5KBb3wsR1-qT1MxTRtu8xRWubKJ0VD7ztEe-RuqqoTOCxdU78--51Q1ik5XUwmNm3CrKsuKQvrUVK3tsQihekU6zCSeJY4IhRi_ENWgr9PkUtbcUWTt34CafwZKrkV7RQc0vA_3EnJk_aWoH8CN0D6E2-N0Nv4IfkWi3xj9054ww4aERr_NfgbPPs_mX_N99Fee9ROHOFt07CCFwgQ2oOQWb9wlQwzLYlLuerouGxweMMpUesf62CtZmh_YrztF-M4oGPHyMUyGHyaDUZ7KK-SuknyRW43KaEzpdE9xE3CJrZtSKiVcoQpvKUfeNIj3TOmF0DZ40dhKSosIUGiUxBPYars2bANDzQ2-Eba0BFA42oBCWCdDYfBaaJ_B69VPrs-WJBp1kXjG_5JIBvskhqsHif863ujOT-qkTnUphbKiMYUPomqM1qLi3BFRkOMah5LB3kqIdVLKeX09hTJ4cdWM6kRnJKYN3QU-gz-D1nCyykBvCH9jQJst7ew0EnPj8hrhMC8yeEXz5PrN__zYnf-P8zncGU3GR_XRx-PDXbhLpe6X2z97sLU4vwhPERAt7LM4638DnP8GIQ |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV3db9MwED9BJ028oPElwgYYCQkJKdAktuPy1rVEg7EJTUXsLfJXtgqUTFuHNF7417lz3dHwIfGYxJc4Pp_9O_vuZ4DnSg5LI22RWtsIItUuU-2bUepyZ3H4c37JwHdwKPc-8ffH4jguuFEuTGzBi1cUVoU1CoM1WfeZa17HPUZ02AUn3i7EJjhjKSluwgbnIzUcwMa4Ovo8W1tlEaIMx-aRTEpCcWvzr-_pTU6Bw78HPH8Pm1yL_QrTUbUFtyOOZOOl4u_ADd_ehc2DuFN-D34E2t8QC9SeMM0qwqZf59-9Y0fziy_pLs5ejo0jozhbdGwaA2M8m1Cqi9P2iiGiZSFFdz15l032p4zylt6wMUrFcecbynWnCOYZhSZe3YdZ9XY22UvjYQup5TJfpEahaWpdWDUqc-3R4VZNIctS2KzMnKGMed0g-tOFE0IZ70RjuJQG8aBQo2HxAAZt1_qHwNCOvWuEKQzBlRxHhEwYK32m8Vool8DLVSPXZ0tKjTqLrON_aCSBXVLDdUFiww43uvOTOhpXXUhRGtHozHnBG62U4HluiTbI5gqrksDOSon1qoPVdEwXoiH00BN4dv0YjYt2THTru0ssg41BHp3kCaie8nsV6j9p56eBphudbQTHeZbAC-onv778z5999N8ln8Lmx2lVf3h3uL8Nt3IEXstloR0YLM4v_WMESgvzJFrDT9CeByo |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Implementing+a+Formalized+Risk-Based+Approach+to+Determine+Candidacy+for+Multidisciplinary+CKD+Care%3A+A+Descriptive+Cohort+Study&rft.jtitle=Canadian+journal+of+kidney+health+and+disease&rft.au=Donald%2C+Maoliosa&rft.au=Weaver%2C+Robert+G&rft.au=Smekal%2C+Michelle&rft.au=Thomas%2C+Chandra&rft.date=2023-01-01&rft.issn=2054-3581&rft.eissn=2054-3581&rft.volume=10&rft.spage=20543581231215865&rft.epage=20543581231215865&rft_id=info:doi/10.1177%2F20543581231215865&rft.externalDBID=NO_FULL_TEXT |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2054-3581&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2054-3581&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2054-3581&client=summon |