The following is a summary of “Patterns of kidney function and risk assessment in a nationwide laboratory database: the Brazilian CHECK-CKD study,” published in the June 2024 issue of Nephrology by Guedes et al.

Chronic kidney disease (CKD) is a growing global threat, but limited data on how physicians assess kidney function, especially in low-income countries, hinders efforts to identify and manage the disease early.

Researchers conducted a retrospective study assessing adherence to kidney function testing guidelines and the role of nephrologists in CKD management in Brazil.

They conducted an observational study utilizing a nationwide laboratory database in Brazil. The analysis included all adult patients who underwent at least 1 serum creatinine assessment (June 2018 to May 2021). The main aim was to identify the percentage of patients receiving an estimated glomerular filtration rate (eGFR) evaluation and predicted urinary albumin-to-creatinine ratio (pACR) assessment within the following 12 months.

The result showed that over 4,5323,332 creatinine tests revealed that 42% of patients did not undergo a pACR within a year despite recommendations. Among the individuals tested, only 10.8% showed signs of CKD, with stage 3a being the most common. Additionally, the likelihood of receiving a creatinine test and a pACR assessment differed depending on the CKD stage. Internal medicine, cardiology, and obstetrics/gynecology departments requested most creatinine tests, while nephrology contributed to only 1.1% of such requests.

Investigators concluded that despite guidelines, many patients with kidney function testing in Brazil lack the recommended urine test, and non-nephrologists manage most evaluations, suggesting a need for earlier CKD detection and collaborative care.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03588-w