Abstract
BackgroundComplications of chronic kidney disease (CKD) contribute to morbidity and mortality. Consequently, treatment guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatment goals in order to initiate timely therapy and referral.MethodsWe performed a web-based survey to assess perceptions and practice patterns in CKD care among 376 family medicine and internal medicine trainees in the United States. Questions were focused on the identification of CKD risk factors, screening for CKD and associated co-morbidities, as well as management of anemia and secondary hyperparathyroidism in patients with CKD.ResultsOur data show that CKD risk factors are not universally recognized, screening for CKD complications is not generally taken into consideration, and that the management of anemia and secondary hyperparathyroidism poses major diagnostic and therapeutic difficulties for trainees.ConclusionEducational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.
Highlights
Complications of chronic kidney disease (CKD) contribute to morbidity and mortality
This belief was supported by the observation that patients with already-established advanced CKD who were referred late to a nephrologist had worse outcomes than those referred earlier [15,16], and several groups of researchers [17,18,19,20] have postulated that CKD care could be improved by early detection, early referral, and a structured approach to CKD care
An analysis based on the National Health and Nutrition Examination Surveys (NHANES) III and Medicare databases showed that CKD care is suboptimal [21], and recent data suggests that primary care providers may not be familiar
Summary
Complications of chronic kidney disease (CKD) contribute to morbidity and mortality. treatment guidelines have been developed to facilitate early detection and treatment. National treatment guidelines for CKD, and for the management of hypertension, dyslipidemia, bone disease, nutrition, anemia and cardiovascular disease in patients with CKD, have been published [6,7,8,9,10,11,12], and dedicated CKD clinics were established based on the conviction that such clinics would help implement Kidney Disease Outcomes Quality Initiative (KDOQI) goals and improve outcomes [13,14] This belief was supported by the observation that patients with already-established advanced CKD who were referred late to a nephrologist had worse outcomes than those referred earlier [15,16], and several groups of researchers [17,18,19,20] have postulated that CKD care could be improved by early detection, early referral, and a structured approach to CKD care. This web-based survey was designed to ascertain perceptions and practice patterns regarding CKD care in family medicine and internal medicine trainees
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