BACKGROUND: Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy. METHODS: A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist. RESULTS: Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases. CONCLUSION: This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.

CLINICAL POLICIES ON THE MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS IN ITALY / F., Locatelli; C., Zoccali; P., Acciarri; Menegato, M. A.; E., Ancarani; V., Andreucci; A., Antonelli; Auricchio, M. R.; A., Balducci; A., Bassi; G., Battaglia; G., Bellingheri; A., Beltrame; M., Biagini; L., Bonfante; Bonofiglio, R; Bonomini, M; Borghi, M; Brigante, M; Buccianti, G; Buongiorno, E; Cabibbe, M; Cancarini, G; Capistrano, M; Cappelli, G; Capuano, M; Cascone, C; Catizone, L; Catucci, Ae; Cavatorta, F; Chiarinotti, D; T., Cicchetti; G., Concas; M., Concetti; F., Conte; M., Conti; Coratelli, P; Corti, M. M.; R., Costanzo; A., Dal Canton; L., D'Apice; David, Salvatore. - In: NEPHROLOGY DIALYSIS TRANSPLANTATION. - ISSN 1460-2385. - 23:(2008), pp. 621-626. [10.1093/ndt/gfm636]

CLINICAL POLICIES ON THE MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS IN ITALY

DAVID, Salvatore
2008-01-01

Abstract

BACKGROUND: Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy. METHODS: A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist. RESULTS: Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases. CONCLUSION: This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.
2008
CLINICAL POLICIES ON THE MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS IN ITALY / F., Locatelli; C., Zoccali; P., Acciarri; Menegato, M. A.; E., Ancarani; V., Andreucci; A., Antonelli; Auricchio, M. R.; A., Balducci; A., Bassi; G., Battaglia; G., Bellingheri; A., Beltrame; M., Biagini; L., Bonfante; Bonofiglio, R; Bonomini, M; Borghi, M; Brigante, M; Buccianti, G; Buongiorno, E; Cabibbe, M; Cancarini, G; Capistrano, M; Cappelli, G; Capuano, M; Cascone, C; Catizone, L; Catucci, Ae; Cavatorta, F; Chiarinotti, D; T., Cicchetti; G., Concas; M., Concetti; F., Conte; M., Conti; Coratelli, P; Corti, M. M.; R., Costanzo; A., Dal Canton; L., D'Apice; David, Salvatore. - In: NEPHROLOGY DIALYSIS TRANSPLANTATION. - ISSN 1460-2385. - 23:(2008), pp. 621-626. [10.1093/ndt/gfm636]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2403536
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