Salar Ibáñez Luis, Espejo Guerrero José, Satué Eduardo, Pérez León Noemí, Martínez-Berganza Asensio M Lourdes
Doctor en farmacia, Director de 'Farmacéuticos Comunitarios', Profesor asociado Universidad Cardenal Herrera - CEU, Farmacéutico comunitario en Valencia Universidad Cardenal Herrera España.
Doctor en Farmacia, Farmacéutico comunitario en Adra (Almería) España.
Farm Comunitarios. 2024 Apr 11;16(2):5-13. doi: 10.33620/FC.2173-9218.(2024).12. eCollection 2024 Apr 15.
Chronic kidney disease (CKD) is the existence of abnormalities in renal structure or function with an impact on health. This is usually considered when estimated glomerular filtration (eGF) falls under 60 mL/min/1.73m. Its clinical course leads to renal replacement therapy (dialysis or transplant) when eGF falls under 15 mL/min/1.73m. Screening in at risk populations has been proven to be cost-effective. The aim of this work is to perform CKD screening in the community pharmacy. In this publication we report and justify the methodology in detail.
Pharmacists from the community pharmacies taking part selected patients who complied with inclusion and not exclusion criteria. Creatinine was measured by means of a finger prick and eGF calculated with the formula CKD-EPI. If this is lower than a set value, which depends on age, referral to the general practitioner takes place.
A total of 141 out of 200 pharmacies took part in the study. In all 2116 patients were recruited and 116 patients were lost. The final sample size was 2000 patients.
The protocol was successfully implemented by community pharmacists and was extremely well received by community pharmacy users. The age adjustment for eGF thresholds provides a novel additional filter. The aim is not to overburden primary care centres with potential referrals of false positives. Confirmation of the diagnosis is subject to voluntary communication by the patient to the pharmacist.
慢性肾脏病（CKD）是指存在影响健康的肾脏结构或功能异常。当估算肾小球滤过率（eGF）低于60 mL/（min·1.73m²）时，通常会考虑诊断为慢性肾脏病。当eGF低于15 mL/（min·1.73m²）时，其临床病程会导致肾脏替代治疗（透析或移植）。在高危人群中进行筛查已被证明具有成本效益。这项工作的目的是在社区药房开展慢性肾脏病筛查。在本出版物中，我们详细报告并论证了该方法。
参与研究的社区药房的药剂师挑选符合纳入标准而非排除标准的患者。通过手指采血测量肌酐，并使用CKD-EPI公式计算eGF。如果该值低于取决于年龄的设定值，则将患者转诊至全科医生处。
200家药房中有141家参与了该研究。总共招募了2116名患者，其中116名患者失访。最终样本量为2000名患者。
该方案由社区药剂师成功实施，并受到社区药房使用者的广泛好评。eGF阈值的年龄调整提供了一个新的附加筛选标准。目的是避免向初级保健中心转诊过多可能的假阳性病例。诊断的确认取决于患者是否自愿向药剂师告知情况。
