J Clin Outcomes Manage
Chronic kidney disease: a brief review for the primary care physician
Balogun RA, Bolton WK
Objective: To review clinical guideline recommendations for the identification and management of chronic kidney disease (CKD). Methods: Qualitative assessment of the literature and review of current management guidelines. Results: The incidence and prevalence of CKD is rising rapidly. Mortality rates are still unacceptably high despite improved technical and medical knowledge in the care of patients with end-stage renal disease (CKD stage 5). Efforts to decrease the morbidity and mortality observed with end-stage renal disease have focused on improving care in the earlier stages of kidney disease. These efforts seek greater involvement from primary care physicians, who have a critical role to play in early identification, treatment, and appropriate referral of patients with CKD. Multiple clinical practice guidelines are available to guide primary care physicians in identifying patients with CKD and in initiating therapy, which includes treatment of the primary disease and comorbid conditions, interventions to prevent progression of kidney disease and complications of CKD, and interventions to maintain a good quality of life. Collaboration with a nephrologist is best initiated no later than stage 3 of CKD. Conclusion: Early recognition of CKD along with timely initiation of comprehensive treatment and collaboration with a nephrologist will provide optimal care for patients with CKD.
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