THE ACCESSIBILITY OF NEPHROLOGICAL CARE AS A PREDICTOR OF CHRONIC DISEASES OF KIDNEYS

Abstract

The chronic kidney diseases are recognized as one of leading problems of modern health care due to high prevalence and unfavorable prognosis. The article considers modern classification of predictors of chronic kidney diseases. It is emphasized that none of known modern classifications of chronic kidney diseases predictors don't take into account medical care accessibility to patients in disease condition as a predictor. It is proposed to consider accessibility of medical care from perspective of macrolevel social factors that represent the most widely background health predictors. The original typology of accessibility of nephrological medical care to patients with chronic kidney disease is proposed, which is implemented through prevention and/or minimization of predictors of the onset of chronic kidney diseases, management of disease progression and nephroprotection modifiable predictors, and renal replacement therapy for patients with chronic kidney disease. The one of reasons of limited accessibility of renal replacement therapy for patients with chronic kidney diseases is transportation problem that is solved in the Saratov region through organization of transportation of dialysis patients and development of domiciliary methods of renal replacement therapy. The restriction of medical care accessibility to patients is considered as an obligatory predictor of the onset, progression and unfavorable prognosis of chronic kidney diseases.