0
Editor's Correspondence |

Impact of Nephrologic Care in the Early Management of Chronic Kidney Disease—Reply

Wolfgang C. Winkelmayer, MD, ScD; Glenn M. Chertow, MD, MPH; Manjula Kurella Tamura, MD, MPH
Arch Intern Med. 2011;171(22):2066-2067. doi:10.1001/archinternmed.2011.588.
Text Size: A A A
Published online

Extract

In reply

We appreciate the comments of the letter writers, all of whom pointed toward an important, perhaps the most important, goal of earlier nephrology care, which is to slow the progression of chronic kidney disease. Our study1 was not designed to investigate this question. Furthermore, these data should not deter any clinician from timely referral to a nephrologist. Our study merely pointed toward certain trends in practice patterns that are unproven and even potentially harmful, including earlier initiation of dialysis and injudicious use of erythropoiesis-stimulating agents. These trends may actually have obscured true advances on other care domains that would otherwise have led to measurably improved outcomes. Our article should serve as a wake-up call toward more rigorous testing of any nephrology-driven interventions and focus on practices that are shown to be both safe and effective.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

December 12, 2011
Jorge C. Busse, MD
Arch Intern Med. 2011;171(22):2066-2067. doi:10.1001/archinternmed.2011.587.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com
brightcove.createExperiences();