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TITLE:

AWARENESS AND APPLICATION OF CREATININE CLEARANCE/eGFR IN NON-NEPHROLOGY DOCTORS

AUTHORS:

Zahid Bashir, Shah Bano, Rabia Yousaf

ABSTRACT:

Introduction: We conducted this study to determine the awareness of usage of estimated GFR / creatinine clearance formulas while dealing with patients, in various wards and outpatient departments of Holy Family/ Benazir Bhutto Hospital Rawalpindi, in doctors who are not working or trained in nephrology, it was done by using a questionnaire in between January 2019 to May 2019.It was found that good percentage of doctor is not using basic formulas and need education by fellow nephrology colleagues for basic patient management , drug dosing and referral. Objective: To study the awareness and usage of creatinine clearance calculations in doctors not trained in nephrology. Methodology: The cross-sectional observational study was conducted. A questionnaire was designed which included questions about knowledge of estimated GFR/creatinine clearance, calculation methods, use of these formulas while dealing with patients for defining and diagnosing AKI and CKD, medicine dosage adjustment according to creatinine clearance and referral to nephrologists. They were further asked about the need of training and education by fellow nephrology colleagues. Answers to each question were recorded and analyzed. Results: A total of 170 doctors working in different specialties were contacted and all of them filled questionnaire. 56(32.9%) doctors answered that they know and calculate eGFR in routine practice while 114(67.1%) were not performing eGFR while encountering patients. 80(47.1%) were confident in staging chronic kidney disease and 90(52.9%) were unable to stage chronic kidney disease on basis of eGFR. Conclusion: Several considerable challenges remain regarding CKD and AKI early diagnosis and management and referral in Pakistan including inadequate knowledge and training systems, and needs education in this regard.

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