You already know about the dangers of Renal Impairment. Your patients may, too. But you may not know if one of your patients is suffering from Renal Impairment, because (as you probably know), an individual can be in a state of mild renal failure and still have normal values return on a lab test.

         There is a formula (distributed by the National Kidney Foundation and also published on the 1996 Scientific American CD-ROM) that allows you to calculate a patient's renal impairment based on the following risk factors:

• Age
• Sex
• Serum Albumin Level
• Creatinine Level
• BUN

The actual formula to determine Renal Impairment is as follows:   

For Men:

Renal Impairment Factor =

  170 * (Serum Albumin Level ^ 0.318) *

  (Patient Age ^ -0.176) *

  (Creatinine Level ^ -0.999) *

  (BUN ^ -0.170)

For Women:

Renal Impairment Factor =

  170 * (Serum Albumin Level ^ 0.318) *

  (Patient Age ^ -0.176) *

  (Creatinine Level ^ -0.999) *

  (BUN ^ -0.170) * 0.762

If the Renal Impairment Factor is

>= 90   then            NORMAL RENAL FUNCTION

>= 60   and < 89 then   MILD RENAL IMPAIRMENT

>= 30   and < 59 then   MODERATE RENAL IMPAIRMENT

<= 29   then            SEVERE RENAL IMPARIMENT

         Most physicians will not be able to take the time to calculate a patient's Renal Impairment Factor, especially if the lab values come back in a normal range.   

         However, with the Team Chart Concept from Ulrich Medical Concepts , you can instantly calculate any patient's Level of Renal Impairment.

         The following Renal Impairment Record is for an actual patient who was under the care of Dr. Dennis Ulrich (a co-founder of Ulrich Medical Concepts ) using the Team Chart Concept:

Doe, Jane (female, age 69)

06-27-2002 Thu 08:40:00 AM

CKD(NKF) - CKD Risk

Microalbuminuria:

Creatinine:            0.9

BUN:                   25

Ser Alb:               4.0

Est CRcl:              61

GFR level:             Mild Renal Impairment

SBP goal:              125

DBP Goal:              75

sbp%:                  80

%DBP Goal:             133

% GFR:                 55

 

         Notice that the Creatinine, BUN, and Serum Albumin levels are all within a normal range. Yet her Renal Impairment Factor (Est CRcl) has a value of 61, just above the limit for Mild Renal Impairment. There exists the possibility that this patient's condition might have been missed had it not been for Dr. Ulrich's use of the Team Chart Concept system. 

         Note that the Creatinine, BUN, and Serum Albumin values were imported (automatically) from standard Laboratory Corporation of America (LabCorp) reports by the Team Chart Concept . In fact, the process of calculating the level of Renal Impairment is entirely automated with the Team Chart Concept .

         As you know, Renal Impairment is a serious condition. You now have a tool to quickly, and easily, check for this life-threatening condition. This is a higher standard of patient care. 

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