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Chronic kidney disease: identification and management in primary care

Chronic kidney disease: identification and management in primary care
Chronic kidney disease: identification and management in primary care
CKD is an important and common non-communicable condition globally. In national and international guidelines it is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end stage kidney disease for most people with CKD. CKD also predisposes to acute kidney injury – a major cause of morbidity and mortality worldwide. Although only a small proportion of people with CKD progress to end stage kidney disease, renal replacement therapy (dialysis or transplantation) represent major costs for health care systems and burden for patients. Efforts in primary care to reduce the risks of cardiovascular disease, acute kidney injury and progression are therefore required. Monitoring renal function is an important task and primary care clinicians are well placed to oversee this aspect of care along with the management of modifiable risk factors, particularly blood pressure and proteinuria. Good primary care judgement is also essential in making decisions about referral for specialist nephrology opinion. As CKD commonly occurs alongside other conditions, consideration of comorbidities and patient wishes is important and primary care clinicians have a key role in coordinating care while adopting a holistic, patient-centred approach and providing continuity. This review aims to summarise the vital role that primary care plays in pre-dialysis CKD care and to outline the main considerations in its identification, monitoring and clinical management in this context.
1179-7266
21-32
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Blakeman, Thomas
c005e534-1e5e-4f74-a3ef-a4f298519399
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Blakeman, Thomas
c005e534-1e5e-4f74-a3ef-a4f298519399

Fraser, Simon D.S. and Blakeman, Thomas (2016) Chronic kidney disease: identification and management in primary care. Pragmatic and Observational Research, 2016:7, 21-32. (doi:10.2147/POR.S97310).

Record type: Article

Abstract

CKD is an important and common non-communicable condition globally. In national and international guidelines it is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end stage kidney disease for most people with CKD. CKD also predisposes to acute kidney injury – a major cause of morbidity and mortality worldwide. Although only a small proportion of people with CKD progress to end stage kidney disease, renal replacement therapy (dialysis or transplantation) represent major costs for health care systems and burden for patients. Efforts in primary care to reduce the risks of cardiovascular disease, acute kidney injury and progression are therefore required. Monitoring renal function is an important task and primary care clinicians are well placed to oversee this aspect of care along with the management of modifiable risk factors, particularly blood pressure and proteinuria. Good primary care judgement is also essential in making decisions about referral for specialist nephrology opinion. As CKD commonly occurs alongside other conditions, consideration of comorbidities and patient wishes is important and primary care clinicians have a key role in coordinating care while adopting a holistic, patient-centred approach and providing continuity. This review aims to summarise the vital role that primary care plays in pre-dialysis CKD care and to outline the main considerations in its identification, monitoring and clinical management in this context.

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More information

Accepted/In Press date: 1 June 2016
e-pub ahead of print date: 17 August 2016
Published date: 17 August 2016
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 396234
URI: https://eprints.soton.ac.uk/id/eprint/396234
ISSN: 1179-7266
PURE UUID: b313abf1-72e5-448c-87d9-87da485bff97
ORCID for Simon D.S. Fraser: ORCID iD orcid.org/0000-0002-4172-4406

Catalogue record

Date deposited: 01 Jun 2016 09:12
Last modified: 06 Jun 2018 12:36

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