repeated serum creatinine measurement in primary care: not all patients have chronic renal failure

Objective: To assess the prevalence of kidney failure in patients from a primary care centre in a basic healthcare district with laboratory availability allowing serum creatinine measurements. Design: An observational descriptive cross-sectional study. Data sources: A basic healthcare district serving 23,807 people aged ≥ 18 years. Results: Prevalence of kidney failure among 17,240 patients having at least one laboratory measurement available was 8.5% (mean age 77.6 ± 12.05 years). In 33.2% of such patients an occult kidney failure was found (98.8% were women). Prevalence of chronic kidney failure among 10,011 patients having at least 2 laboratory measurements available (≥3 months apart) was 5.5% with mean age being 80.1 ± 10.0 years (most severely affected patients were those aged 75–84); 59.7% were men and 76.3% of cases were in stage 3. An occult kidney failure was found in 5.3% of patients with women being 86.2% of them (a glomerular filtration rate < 60 mL/min was estimated for plasma creatinine levels of 0.9 mg/dl or higher). Conclusions: Comparison of present findings to those previously reported demonstrates the need for further studies on the prevalence of overall (chronic and acute) kidney failure in Spain in order to estimate the real scope of the disease. Primary care physicians play a critical role in disease detection, therapy, control and recording (in medical records). MDRD equation is useful and practical to estimate glomerular filtration rate.