http://www.nephrologynow.com/publications/asn-podcast-on-egfr-measurement Tue, 24 Aug 2010 16:29:14 +0000 hourly 1 http://wordpress.org/?v=3.0.1 http://www.nephrologynow.com/publications/asn-podcast-on-egfr-measurement/comment-page-1#comment-124 Mario T. Parise Md. Tue, 20 Oct 2009 00:12:23 +0000 http://www.nephrologynow.com/?p=1195#comment-124 I work in Sun City AZ. where the average age of my patients is ~80+ years old where demographically, there are 4 times a many women as men. I see to many healthy "e" GFR consults monthly and have developed a method to ensure the patient leaves my office less frightened than when they came and to instill convidence in referring primaries. I explain to both the elderly bias of "e" GFR, calculate their age adjusted GFR ( using a loss of .8% / yr from age 30yo) and see the patient back with a renal ultra sound,I-PTH, and CBC. I feel if they are not anemic, do not have 2ndary hyperpara. and have a cortex of 10mm or greater there is little chance of progressive disease in this patient. I justify my charges by admonishing against the use of NSAIDS and preach caution with regard to any "dye" procedures in the future and recomend mucomyst and hydration prior to these studies. The podcast implied a problem with the CKD stages. The biggest problem for me is that the staging makes everyone over the age of 80 have CKD. I would prefer an age adjusted classification as well as CKD-3 A, B +/- Prot. The cast was very informative and I have already forwarded it to several primaries. Perhaps it will appear in places that primaries will be able to see it. Very well done. Thank You, M.T Parise Md. I work in Sun City AZ. where the average age of my patients is ~80+ years old where demographically, there are 4 times a many women as men. I see to many healthy “e” GFR consults monthly and have developed a method to ensure the patient leaves my office less frightened than when they came and to instill convidence in referring primaries.
I explain to both the elderly bias of “e” GFR, calculate their age adjusted GFR ( using a loss of .8% / yr from age 30yo) and see the patient back with a renal ultra sound,I-PTH, and CBC. I feel if they are not anemic, do not have 2ndary hyperpara. and have a cortex of 10mm or greater there is little chance of progressive disease in this patient.
I justify my charges by admonishing against the use of NSAIDS and preach caution with regard to any “dye” procedures in the future and recomend mucomyst and hydration prior to these studies.
The podcast implied a problem with the CKD stages. The biggest problem for me is that the staging makes everyone over the age of 80 have CKD. I would prefer an age adjusted classification as well as CKD-3 A, B +/- Prot.
The cast was very informative and I have already forwarded it to several primaries. Perhaps it will appear in places that primaries will be able to see it. Very well done. Thank You, M.T Parise Md.

]]>