CKD as an underrecognized threat to patient safety

Am J Kidney Dis. 2009 Apr;53(4):681-8. doi: 10.1053/j.ajkd.2008.12.016. Epub 2009 Feb 26.


Chronic kidney disease (CKD) is common, but underrecognized, in patients in the health care system, where improving patient safety is a high priority. Poor disease recognition and several other features of CKD make it a high-risk condition for adverse safety events. In this review, we discuss the unique attributes of CKD that make it a high-risk condition for patient safety mishaps. We point out that adverse safety events in this disease have the potential to contribute to disease progression; namely, accelerated loss of kidney function and increased incidence of end-stage renal disease. We also propose a framework in which to consider patient safety in CKD, highlighting the need for disease-specific safety indicators that reflect unsafe practices in the treatment of this disease. Finally, we discuss the hypothesis that increased recognition of CKD will reduce disease-specific safety events and in this way decrease the likelihood of adverse outcomes, including an accelerated rate of kidney function loss and increased incidence of end-stage renal disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Chronic Disease
  • Disease Progression
  • Humans
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / physiopathology
  • Kidney Diseases / therapy*
  • Medical Errors / adverse effects*
  • Prognosis
  • Risk Factors