American journal of kidney diseases : the official journal of the National Kidney Foundation
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Comparative Study
Comparison of 2 acute renal failure severity scores to general scoring systems in the critically ill.
Several proposed definitions for acute renal failure (ARF) exist, but little is known of their significance in clinical practice. We evaluated the ability to predict hospital mortality in 2 ARF-specific severity-of-illness scoring methods, the Risk, Injury, Failure, Loss, End-Stage Renal Disease (RIFLE) score and the score presented by Bellomo et al in 2001. ⋯ Neither of the ARF-specific scoring methods presented good discriminative power regarding hospital mortality. However, maximum RIFLE score for the first 3 days in the ICU was found to be an independent predictor of hospital mortality, along with admission SOFA score.
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It is unclear whether primary care physicians (PCPs) and nephrologists differ in their recognition of progressive chronic kidney disease (CKD), agree on diagnostic and referral strategies, and identify similar barriers to caring for patients. ⋯ PCPs recognize and recommend specialist care for progressive CKD less than nephrologists and differ in their clinical evaluations and expectations for referral. Improved dissemination of existing guidelines and targeted education in conjunction with efforts to build consensus among PCPs and nephrologists regarding their roles in the care of patients with CKD, including the collaborative development of clinical practice guidelines, could enhance patient care.