Screening for chronic kidney disease in Belgrade Primary Health Care Centers

Abstract

Introduction. Academy of Medical Science of Serbian Medical Society
introduced collaboration between Belgrade nephrologists
and general practitioners with the aim of examining the prevalence
of chronic kidney disease (CKD) in populations at risk as well as of
checking whether collaboration with general practitioners contributed
to implementation of regular CKD screening.
Methods. The research encompassed two studies carried out in
four Belgrade Primary Health Care Centers. The screening study involved
619 patients at risk for CKD (348 with hypertension, 206 with
diabetes, 65 persons aged > 60 years without hypertension/diabetes)
in whom glomerular filtration rate (eGFR) was estimated by
MDRD formula, while urine dipstick test was used for detection of
proteinuria and albuminuria (Micral-test® strips).The second study
was retrospective analysis of medical records of 450 patients who
were examined in the screening study and whose blood pressure
and eGFR recording were analyzed during three-year period.
Results. In screening study, eGFR below 60 ml/min/1.73m2 was
detected in 121 (19.55%) and albuminuria in 242 (39.10%) patients.
During three-year retrospective study, percentage of patients
whose blood pressure and eGFR were recorded decreased
from 42% to 22% and from 42% to 18%, respectively. Multivariate
regression analysis selected health center, systolic blood pressure
and hypertension as the variables significantly associated with the
number of years in which blood pressure was recorded, while male
gender, health center, hypertension and basal eGFR as variables
associated with the number of years in which eGFR was recorded.
Conclusion. Despite collaboration between nephrologists and
general practitioners in screening study, the retrospective threeyear
study revealed insufficient recording of blood pressure and
eGFR in patients’ medical records.