Clinical policies on the management of chronic kidney disease patients in Italy

Francesco Locatelli, Carmine Zoccali, Piermarino Acciarri, Massimo Adorati Menegato, Enzo Ancarani, Vittorio Andreucci, Alessandro Antonelli, Maria Rita Auricchio, Alessandro Balducci, Antonio Bassi, Giovanni Battaglia, Guido Bellingheri, Alessandra Beltrame, Marco Biagini, Luciana Bonfante, Renzo Bonofiglio, Mario Bonomini, Marcello Borghi, Maurizio Brigante, Gherardo BucciantiErasmo Buongiorno, Mara Cabibbe, Giovanni Cancarini, Mariano Capistrano, Giorgio Cappelli, Maria Capuano, Carmelo Cascone, Luigi Catizone, Angelo Emanuele Catucci, Fosco Cavatorta, Doriana Chiarinotti, Teresa Cicchetti, Gabriella Concas, Massimo Concetti, Ferruccio Conte, Maura Conti, Pasquale Coratelli, Mauro Maria Corti, Riccardo Costanzo, Antonio Dal Canton, Ludovica D'Apice, Salvatore David, Vincenzo De Cristofaro, Giacomo Deferrari, Franco Della Grotta, Luca De Nicola, Natale Gaspare De Santo, Walter De Simone, Nicola Di Daniele, Salvatore Di Giulio, Domenico Di Landro, Virgilio Di Luzio, Arcangelo Di Maggio, Riccardo Fagugli, Marco Farina, Mariano Feriani, Maurizio Gallieni, Giovanni Gambaro, Rosa Giordano, Simona Greco, Carlo Grillo, Walter Huber, Gabriele Liuzzo, Luigi Lombardi, Teodoro Lopez, Fabio Malberti, Walter Mancini, Flavia Manenti, Gianfranco Manisco, Antonino Marrocco, Giampaolo Matocci, Graziana Merico, Piergiorgio Messa, Roberto Minutolo, Paolo Monardo, Luigi Moriconi, Paola Murrone, Alfio Nardo, Agostino Naso, Rosario Nobile, Giacomo Panarello, Antonio Paone, Mauro Parravano, Luciano Pedrini, Valter Piazza, Raffaele Pistis, Mario Procida, Francesco Quarello, Francesco Rapisarda, Biagio Ricciardi, Paolo Rindi, Claudio Ronco, Ugo Rotolo, Giorgia Russo, Antonello Saraniti, Mauro Sasdelli, Vincenzo Savica, Renzo Scanziani, Antonio Sidoti, Donatella Spotti, Andrea Stalteri, Sergio Stefoni, Andrea Stella, Paolo Strippoli, Ugo Teatini, Concettina Teodoro, Carmela Tozzo, Giorgio Triolo

Research output: Contribution to journalArticle

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 ∼40% of cases. Conclusion. This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.

Original languageEnglish
Pages (from-to)621-626
Number of pages6
JournalNephrology Dialysis Transplantation
Volume23
Issue number2
DOIs
Publication statusPublished - Feb 2008

Keywords

  • Chronic kidney disease
  • Guidelines
  • Italy
  • Management

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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  • Cite this

    Locatelli, F., Zoccali, C., Acciarri, P., Menegato, M. A., Ancarani, E., Andreucci, V., Antonelli, A., Auricchio, M. R., Balducci, A., Bassi, A., Battaglia, G., Bellingheri, G., Beltrame, A., Biagini, M., Bonfante, L., Bonofiglio, R., Bonomini, M., Borghi, M., Brigante, M., ... Triolo, G. (2008). Clinical policies on the management of chronic kidney disease patients in Italy. Nephrology Dialysis Transplantation, 23(2), 621-626. https://doi.org/10.1093/ndt/gfm636