A growing body of evidence indicates that therapeutic interventions such as strict blood pressure control, use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) at earlier stages of chronic kidney disease are effective in slowing the progression of chronic kidney disease. However, it is widely believed that CKD is """"""""under-diagnosed"""""""" and """"""""under-treated"""""""" in the United States resulting in lost opportunities for prevention. Few studies have tried to assess the factors associated with poor recognition and treatment of CKD. In this study we will send a questionnaire to a random sample of primary care physicians from AMA Master File. These questionnaires will look at physician ability to recognize CKD in men and women of different age groups, their attitude towards blood pressure goals and use of ACE inhibitors and ARBs in patients with CKD and their beliefs about risk of cardiovascular disease in the setting of CKD. We will then analyze the data to derive physician characteristics i.e. year of graduation; that are associated with better ability to recognize CKD and attitudes towards managing patients with CKD that are in line with current literature and guidelines. ? ?
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Brunelli, Steven M; Joffe, Marshall M; Israni, Rubeen K et al. (2008) History-adjusted marginal structural analysis of the association between hemoglobin variability and mortality among chronic hemodialysis patients. Clin J Am Soc Nephrol 3:777-82 |
Yang, Wei; Israni, Rubeen K; Brunelli, Steven M et al. (2007) Hemoglobin variability and mortality in ESRD. J Am Soc Nephrol 18:3164-70 |