A general practitioner's perspective on renal care

Abstract

Until recently, the care of renal patients has been largely the domain of nephrologists. However, as a rising number of people are diagnosed with chronic kidney disease (CKD), along with the more active treatment of end-stage renal disease, more of the care has been streamlined into nurse-led clinics, and the earlier stages of renal disease are now being managed in the community. Looking at the overall number of patients within primary care, those with end-stage renal failure comprise only a tiny proportion. The UK annual incidence of stage 5 CKD is about 100 per million population (Hamer and El Nahas, 2006). This would mean that in a practice of 8000 patients, a GP would expect each year, on average, to have only one (or no) patients with newly diagnosed end-stage renal disease. Likewise, as the prevalence of people who rely on dialysis or transplant for survival is 600 to 800 per million, the same practice would expect five or six such patients on its list at any one time.