Background
Methods
Patients
Dedicated CKD clinic
Data collection
Statistical analysis
Results
Patient characteristics
All (N = 198) | LNC† (N = 146) | SNC† (N = 52) | P-value | |
---|---|---|---|---|
Ethnicities | ||||
Hispanic | 46% | 44% | 54% | 0.214 |
African American | 43% | 48% | 31% | 0.032 |
Haitian | 7% | 7% | 8% | 0.839 |
Caucasian | 3% | 1% | 5% | 0.083 |
Asian | 1% | 0% | 2% | 0.093 |
Age [Years]
| ||||
Mean ± SD | 56 ± 13.4 | 51 ± 14 | 58 ± 12.7 | 0.001 |
<31 | 4% | 1% | 10% | 0.006 |
31–40 | 10% | 8% | 14% | 0.270 |
41–50 | 20% | 19% | 21% | 0.758 |
51–60 | 25% | 23% | 31% | 0.241 |
61–70 | 28% | 32% | 17% | 0.041 |
71–80 | 12% | 13% | 8% | 0.304 |
>80 | 3% | 3% | 2% | 0.176 |
Gender
| ||||
Female | 53% | 55% | 48% | 0.405 |
CKD Stage
| ||||
Stage 4 | 47% | 48% | 44% | 0.645 |
Length of Nephrology Care [Months]
| ||||
0–1 | 9% | 0% | 35% | - |
2–6 | 17% | 0% | 65% | - |
7–12 | 14% | 20% | 0% | - |
13–24 | 15% | 22% | 0% | - |
24–36 | 15% | 21% | 0% | - |
>36 | 30% | 44% | 0% | - |
Co-Morbidities
| ||||
Hypertension | 92% | 95% | 83% | 0.004 |
Hyperlipidemia | 66% | 71% | 52% | 0.015 |
Diabetes | 50% | 45% | 65% | 0.008 |
Estimated GFR at Referral to Nephrology [ml/min/1.73 m
2
]
| ||||
Mean ± SD | 26 ± 14.9 | 29 ± 15.7 | 17 ± 8.3 | <0.001 |
<15 | 21% | 13% | 42% | <0.001 |
15–29 | 52% | 51% | 52% | 0.945 |
30–59 | 24% | 31% | 6% | <0.001 |
>59 | 4% | 5% | 0% | 0.108 |
Achievement of K/DOQI goals
Stage 4 CKD | Stage 5 CKD | ||||
---|---|---|---|---|---|
SNC† (N = 23) | LNC† (N = 70) | SNC† (N = 29) | LNC† (N = 76) | p-values | |
Estimated GFR [ml/min/1.73 m2] | 22 ± 4* | 21 ± 4#
| 9.1 ± 3* | 9.1 ± 3#
| *#<0.001 |
Calcium [mg/dl] | 9.5 ± 0.6 | 9.3 ± 0.6* | 8.9 ± 0.9 | 8.9 ± 0.8* | *0.015 |
Phosphate [mg/dl] | 4.6 ± 1.1 | 4.1 ± 0.9* | 5.2 ± 1.2 | 5.3 ± 1.5* | *<0.001 |
Calcium-Phosphate Product [mg2/dl2] | 45 ± 11 | 38 ± 9*#
| 46 ± 10#
| 47 ± 13* | *<0.001; #0.035 |
iPTH [pg/ml] | 155 ± 153* | 203 ± 152#
| 532 ± 476* | 486 ± 385#
| *0.008; #<0.001 |
Bicarbonate [mmol/l] | 23 ± 4 | 25 ± 4*#
| 21 ± 5#
| 21 ± 4* | *#<0.001 |
Albumin [g/dl] | 3.3 ± 0.8 | 3.8 ± 0.5 | 3.5 ± 0.7 | 3.6 ± 0.6 | |
Hemoglobin [g/dl] | 11.3 ± 2.0 | 11.8 ± 1.2*#
| 10.3 ± 1.9#
| 10.5 ± 1.8* | *<0.001; #0.003 |
Total Cholesterol [mg/dl] | 190 ± 37 | 189 ± 40 | 180 ± 56 | 172 ± 41 | |
Triglycerides [mg/dl] | 153 ± 72 | 176 ± 120 | 183 ± 115 | 149 ± 85 | |
LDL [mg/dl] | 111 ± 30 | 103 ± 34 | 100 ± 49 | 94 ± 33 | |
HDL [mg/dl] | 48 ± 16 | 53 ± 15* | 43 ± 15* | 47 ± 16 | *0.033 |
Non-HDL [mg/dl] | 142 ± 38 | 137 ± 39 | 137 ± 54 | 125 ± 37 | |
Systolic Blood Pressure [mmHg] | 148 ± 27 | 135 ± 26* | 155 ± 27* | 147 ± 28 | |
Diastolic Blood Pressure [mmHg] | 82 ± 21 | 73 ± 14* | 84 ± 17* | 77 ± 16 | *0.049 |
Stage 4 CKD | Stage 5 CKD | |||||
---|---|---|---|---|---|---|
SNC† (N = 23) | LNC† (N = 70) | p-value | SNC† (N = 29) | LNC† (N = 76) | p-value | |
Calcium | 87% | 91% | 0.529 | 79% | 82% | 0.791 |
Phosphate | 48% | 80% | 0.003 | 52% | 66% | 0.185 |
Calcium-Phosphate Product | 65% | 94% | <0.001 | 83% | 78% | 0.789 |
iPTH | 9% | 20% | 0.213 | 24% | 21% | 0.733 |
Bicarbonate | 70% | 81% | 0.230 | 38% | 49% | 0.323 |
Albumin | 43% | 76% | 0.004 | 48% | 62% | 0.208 |
Hemoglobin | 57% | 77% | 0.056 | 38% | 42% | 0.697 |
Lipids | 35% | 49% | 0.249 | 34% | 49% | 0.191 |
Triglycerides | 91% | 94% | 0.614 | 90% | 96% | 0.207 |
LDL | 39% | 53% | 0.253 | 48% | 55% | 0.521 |
Non-HDL | 52% | 63% | 0.253 | 66% | 76% | 0.249 |
Blood Pressure | 17% | 34% | 0.132 | 10% | 17% | 0.382 |
Stage 4 CKD#
| Stage 5 CKD#
| |||||
---|---|---|---|---|---|---|
Parameters at goal* | SNC† (N = 23) | LNC† (N = 70) | p-value | SNC† (N = 29) | LNC† (N = 76) | p-value |
0–1 | 0% | 0% | 0% | 5% | ||
2–3 | 39% | 3% | 34% | 28% | ||
4–5 | 26% | 30% | 52% | 26% | ||
6–7 | 35% | 54% | 14% | 36% | ||
8–9 | 0% | 13% | 0% | 5% | ||
Mean ± SD | 4.3 ± 1.8 | 6.0 ± 1.3 | 0.001 | 4.1 ± 1.4 | 4.6 ± 2.0 | 0.477 |