A survey of chronic kidney disease in a large hospital in China

Abstract

Background. Chronic kidney disease (CKD) has emerged as a serious public health problem worldwide. How a CKD program should be organized, though, is still unknown. Therefore, we conducted a study to investigate the burden of CKD in a large university hospital and explore the possible approaches to care CKD appropriately in China. Methods. This is a retrospective cohort study of all new cases of CKD in a large hospital determined by a persistently increased serum creatinine (SCr) level (> 1.47 mg/dL, > 130 umol/L for more than three months) measured in the hospital laboratory. An abbreviate MDRD equation was used to estimate GFR from initial SCr values. Results. There was a large CKD population in the hospital. In all, 1,006 cases had definite chronic kidney disease. Excepting the nephrology department, CKD patients were distributed in 18 disciplines and departments, with the focus on outpatient department and emergency department. In total, 1,257 cases were suspicious of CKD, who had only one or two tests of serum creatinine without detailed follow-up data. Furthermore, when SCr level is higher than 442 umol/L, there were 129 cases with only one test result. Conclusion. CKD is a great burden in the hospital. Multidiscipline cooperation based on outpatient, emergency department, and good follow-up system establishments are necessary for appropriate CKD care. Future work is needed to explore how to organize a good CKD management program to advance the care of patients with CKD.