Potential application of the National Kidney Foundation's chronic kidney disease guidelines in a managed care setting.
Chronic kidney disease (CKD) is a public health problem in the United States with rising incidence and prevalence. The disease may progress to end-stage renal disease, which is associated with significant morbidity and mortality. The National Kidney Foundation recently established clinical practice guidelines to aid in the identification and stratification of CKD. Central to these guidelines is the use of glomerular filtration rate estimation equations. Integrated healthcare systems can use the guidelines to identify patients with CKD early in its course. Early identification allows for timely nephrology referral, institution of measures to slow the progression of CKD, and treatment of CKD-specific complications. Administration of these efforts early in the course of CKD improves subsequent morbidity and mortality of affected patients. By identifying CKD early in its course, patients can be referred to a coordinated case management team that can help administer care. The team can follow up a patient from the early diagnosis of CKD to end-stage renal disease and renal replacement therapy. Finally, continuous quality improvement can be instituted to assist in improving patient care.
Lake Road Nephrology Center, Kaiser Kidney Program, Kaiser Permanente Northwest, Milwaukie, Ore 97267, USA. micahthorp@comcast.net
Micah L
ML
Thorp
Loris
L
Eastman
D042241:Early Diagnosis; D005582:Foundations; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy*; D008329:Managed Care Programs; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D014481:United States