Glomerular Filtration Rate (GFR) Reporting on Nephrology Referral Patterns by Internists

The addition of an estimate value of glomerular filtration rate (GFR) per Modification of Diet in Renal Disease [MDRD] (LEVEY) equation is being included and reported on all routine chemistry panels in the experimental group. The control group is only having serum creatinine, the current standard of care, reported on routine chemistry panels.

All patients already referred to or being followed by nephrologists were excluded. Inclusion criteria were all patients in the Internal Medicine clinic at NMCSD who were sent to the lab to obtain routine chemistry panels for follow up by their primary care providers. The primary outcome is increased referral to nephrology in accordance with NKF K/DOQI guidelines if GFR values are reported on routine chemistry panels. Key secondary outcomes are Primary Care Provider knowledge of NKF K/DOQI guidelines, specifically when patients with chronic kidney disease need to be referred to a nephrologist for further evaluation.

Inclusion Criteria:

• All patients in the Internal Medicine Clinic at Naval Medical Center, San Diego (NMCSD) who were sent to the lab to obtain follow up by their primary care providers.

Exclusion Criteria:

• All patients referred to or being followed by nephrologists.