Renal Ultrasound Use for CKD Patients Unchanged Despite Guidelines
NATIONAL HARBOR, Md.—Renal ultrasound use for patients with chronic kidney disease (CKD) has not changed significantly since the release of guidelines in 2002 recommending imaging studies for patients with CKD or who are at risk for it as a result of urinary stones, infections, and other factors, according to a study of U.S. veterans presented at the National Kidney Foundation 2012 Spring Clinical Meetings.
Nadia Chaudhri, MD, and Stephen Seliger, MD, of the University of Maryland Medical Center and Baltimore VA Medical Center in Baltimore, studied 127,155 active outpatients with CKD who had renal ultrasound studies performed from October 1, 2002 to September 30, 2006. This group represented 12% of veterans with CKD receiving care during that period. The researchers observed no significant change in renal ultrasound usage during the study period.
Patients with an estimated glomerular filtration rate (eGFR) of 15-30 mL/min/1.73 m2 had the highest rate of renal ultrasound studies.Compared with patients who had an eGFR of 45-60, those with an eGFR of 30-45 were 41% more likely to have had a renal ultrasound. Those with an eGFR of 15-30 and below 15 were 19% and 88% less likely to have had a renal ultrasound. A nephrology clinic visit was associated with a 15-fold increased likelihood. African-American race, peripheral artery disease, and diabetes mellitus increased the likelihood of a renal ultrasound by 51%, 61%, and 32%, respectively.