Vnitr Lek 2006, 52(4):308-312

Chronic nephropathies and disorders of renal function - is it sufficiently diagnosed in patients hospitalised on department of internal medicine and cardiology?

Z. Michelová¹, M. Horáčková^1,*, J. Pafčugová¹, M. Hrašková¹, K. Matoušovic¹, M. Kvapil¹, J. Páleníčková²

¹ Interní klinika 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Milan Kvapil, CSc.

² Kardiologická klinika 2. lékařské fakulty UK a FN Motol, přednosta doc. MUDr. Josef Veselka, CSc., FESC, FSCAI

We have found out that nephropathies and renal dysfunctions are diagnosed insufficiently. At the same time, it has been observed that patients are sent to nephrology out-patient clinics too late. The aim of our study was to identify how nephropathy and renal dysfunction are diagnosed and how these diagnoses are recorded in diagnostic summary of hospital discharge report in patients hospitalized in department of internal medicine and cardiology of a big teaching hospital. Also, we studied the incidence of risk diseases (arterial hypertension and diabetes mellitus) and serious cardiovascular complications in individual stages of renal dysfunction. We analysed 325 medical records of patients hospitalized and discharged in the course of one month. Renal dysfunction was classified according to Kidney Disease Outcomes Quality Initiative. Glomerulal filtration rate was calculated via simplified Levey's formula. Nephropathy and renal dysfunction were diagnosed, and properly recorded in diagnostic summary, only in 5 % of patients in the Stage I of renal dysfunction (Stage II = 2%, Stage III = 28%, Stage IV = 88% and Stage V = 88%). The incidence of risk diseases and cardiovascular complications increased linearly with progression of renal insufficiency. The results of our study prove that nephropathy and renal dysfunction are diagnosed insufficiently, particularly in early stages when it is still possible to use targeted therapy and early control of specific complications of renal insufficiency.

Keywords: nephropathy; renal dysfunction; classification K, DOQI

Received: November 21, 2005; Accepted: January 4, 2006; Published: April 1, 2006  Show citation