PMID- 25427285
OWN - NLM
STAT- MEDLINE
DCOM- 20150713
LR  - 20231110
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 11
DP  - 2014
TI  - Primary care detection of chronic kidney disease in adults with type-2 diabetes: 
      the ADD-CKD Study (awareness, detection and drug therapy in type 2 diabetes and 
      chronic kidney disease).
PG  - e110535
LID - 10.1371/journal.pone.0110535 [doi]
LID - e110535
AB  - This US, multicenter, observational study assessed the CKD prevalence in adult 
      patients with type-2 diabetes mellitus (T2DM) and characterized the proportion of 
      detected and undiagnosed CKD in the primary care setting using the following: a 
      clinician survey; a patient physical exam and medical history; a single blood 
      draw for estimated glomerular filtration rate (eGFR) and glycosolated hemoglobin 
      (HbA1c); urine dipstick for protein; urine albumin-creatinine ratio (ACR); two 
      patient quality of life questionnaires; and a 15-month medical record review. The 
      study consisted of 9339 adults with T2DM and 466 investigator sites. Of the 9339 
      enrolled, 9307 had complete data collection for analysis. The 15-month 
      retrospective review showed urine protein, urine ACR, and eGFR testing were not 
      performed in 51.4%, 52.9% and 15.2% of individuals, respectively. Of the 9307 
      patients, 5036 (54.1%) had Stage 1-5 CKD based on eGFR and albuminuria; however, 
      only 607 (12.1%) of those patients were identified as having CKD by their 
      clinicians. Clinicians were more successful in diagnosing patients with Stage 3-5 
      CKD than Stages 1 and 2. There were no differences in clinicians' likelihood of 
      identification of CKD based on practice setting, number of years in practice, or 
      self-reported patients seen per week. Awareness or patient self-reported CKD was 
      81.1% with practitioner detection versus 2.6% in the absence of diagnosis. 
      Primary care of T2DM demonstrates recommended urine CKD testing is underutilized, 
      and CKD is significantly under-diagnosed. This is the first study to show CKD 
      detection is associated with awareness.
FAU - Szczech, Lynda A
AU  - Szczech LA
AD  - Durham Nephrology Associates, Durham, North Carolina, United States of America.
FAU - Stewart, Rebecca C
AU  - Stewart RC
AD  - Scientific Activities Department, The National Kidney Foundation, Inc., New York, 
      New York, United States of America.
FAU - Su, Hsu-Lin
AU  - Su HL
AD  - Covance Inc., Princeton, New Jersey, United States of America.
FAU - DeLoskey, Richard J
AU  - DeLoskey RJ
AD  - Covance Inc., Princeton, New Jersey, United States of America.
FAU - Astor, Brad C
AU  - Astor BC
AD  - Departments of Medicine and Population Health Sciences, University of Wisconsin 
      School of Medicine and Public Health, Madison, Wisconsin, United States of 
      America.
FAU - Fox, Chester H
AU  - Fox CH
AD  - Department of Family Medicine, University at Buffalo, Buffalo, New York, United 
      States of America.
FAU - McCullough, Peter A
AU  - McCullough PA
AD  - Baylor Health Care System, Baylor Heart and Vascular Institute, Dallas, Texas, 
      United States of America.
FAU - Vassalotti, Joseph A
AU  - Vassalotti JA
AD  - Scientific Activities Department, The National Kidney Foundation, Inc., New York, 
      New York, United States of America; Department of Medicine, Division of 
      Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, United 
      States of America.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20141126
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Albuminuria/*urine
MH  - Awareness
MH  - Creatinine/*urine
MH  - Diabetes Mellitus, Type 2/complications/diagnosis/physiopathology/*urine
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Glycated Hemoglobin/metabolism
MH  - Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Primary Health Care/*statistics & numerical data
MH  - Quality of Life
MH  - Renal Insufficiency, Chronic/complications/diagnosis/physiopathology/*urine
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Surveys and Questionnaires
PMC - PMC4245114
COIS- Competing Interests: The study was financially sponsored by Boehringer Ingelheim 
      Pharmaceuticals Inc. and Eli Lilly and Co., but the National Kidney Foundation 
      was responsible for the design and conduct of the study; collection, management, 
      analysis and interpretation of the data; and preparation, review and approval of 
      the manuscript. Richard J. Deloskey and Hsu-Lin Su are employed by Covance Inc. 
      Compensation at Covance is not dependent on the results of the study presented in 
      the manuscript. Lynda A. Szczech is a nephrologist employed by Durham Nephrology 
      Associates. Her compensation is not dependent on the results of the study 
      presented in the manuscript. These interests do not alter the authors' adherence 
      to all PLOS ONE policies on sharing data and materials.
EDAT- 2014/11/27 06:00
MHDA- 2015/07/15 06:00
PMCR- 2014/11/26
CRDT- 2014/11/27 06:00
PHST- 2014/05/19 00:00 [received]
PHST- 2014/09/22 00:00 [accepted]
PHST- 2014/11/27 06:00 [entrez]
PHST- 2014/11/27 06:00 [pubmed]
PHST- 2015/07/15 06:00 [medline]
PHST- 2014/11/26 00:00 [pmc-release]
AID - PONE-D-14-21749 [pii]
AID - 10.1371/journal.pone.0110535 [doi]
PST - epublish
SO  - PLoS One. 2014 Nov 26;9(11):e110535. doi: 10.1371/journal.pone.0110535. 
      eCollection 2014.