Kidney disease

Issue: BCMJ, vol. 47 , No. 9 , November 2005 , Pages 473 Letters

The articles on chronic kidney disease in the July BCMJ (2005;47[6]:286-311) confirmed my experience managing 90 patients in my practice with stage three and four renal failure. I used the guidelines and protocol recommendations to investigate and treat patients. This has resulted in significant alterations and improvements in their care. I have found several calcium phosphate and parathyroid hormone abnormalities and several untreated hyperlipidemias. I have found two asymptomatic renal cancers and one solitary kidney by doing routine renal ultrasounds. I have discontinued renal toxic drugs, modified diets, and treated blood pressures to target. The project has been very satisfying professionally.

The standardization of creatinine and estimated GFR has definitely helped uncover several cases in my practice. I first identified each case with a unique ICD (International Classification of Diseases). I used the ICD 585 to facilitate computer recall of patients and then I arranged for my lab to do the recommended blood tests every 6 months indefinitely. Patients without a previous computerized tomography or ultrasound had a renal ultrasound ordered.

Unfortunately, the General Practice Services Committee and the government have not chosen renal disease as the next chronic disease module, choosing instead hypertension. It was also disappointing to see that the chronic disease module concept has been devalued to $50 for hypertension. Most early renal failure patients have hypertension and their management is at least as complex and time-consuming as diabetes. The government would do well to find money now to fund this chronic disease module, recognizing that aggressive management of stage three and four renal disease will prevent progression of costly dialysis.

BC is fortunate to have the standardized creatinine and estimated GFR, and the guidelines and protocols to identify and manage early renal failure. I encourage general practitioners to manage their renal disease and to keep their patients out of dialysis units. Finally, I would like to thank Dr A. Levin and Dr A. Garg and their associates for giving family doctors the tools to provide excellent care for our chronic kidney disease patients.

—R.J. Calder, MD
Osoyoos

R.J. Calder, MD. Kidney disease. BCMJ, Vol. 47, No. 9, November, 2005, Page(s) 473 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply