title: Overcoming barriers to the early detection and treatment of chronic kidney disease and improving outcomes for end-stage renal disease.
abstract: Chronic kidney disease (CKD) is a growing public health problem. Morbidity and mortality rates from CKD and end-stage renal disease remain high despite the advent of new knowledge, therapies, and clinical practice guidelines. Consequently, the reasons for the underdiagnosis and undertreatment of CKD must be addressed and appropriate preventive and therapeutic interventions implemented. Managed care organizations (MCOs) can facilitate this process by implementing intervention programs that target clinicians and patients with kidney disease. These programs should promote 1) early detection of CKD and comorbid conditions; 2) use of appropriate outcome measures to stratify patient care; 3) implementation of strategies to delay disease progression and prevent or treat complications; and 4) adequate preparation for and timely initiation of renal replacement therapy. Early detection and proactive care of predialysis patients not only improve outcomes and quality of life, but also reduce costs for society and MCOs.
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Brian J G
authors.initials: BJ
authors.lastname: Pereira
mesh_terms: D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D000068256:Darbepoetin alfa; D004502:Education, Medical, Continuing; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000031:analogs & derivatives / Q000627:therapeutic use; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008329:Managed Care Programs / Q000592:standards*; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D011314:Preventive Health Services; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D011994:Recombinant Proteins; D006435:Renal Dialysis; D014481:United States / Q000453:epidemiology
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa