Chronic kidney disease care delivered by US family medicine and internal medicine trainees: results from an online survey.
BACKGROUND
Complications 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.


METHODS
We 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.


RESULTS
Our 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.


CONCLUSIONS
Educational efforts are needed to raise awareness of clinical practice guidelines and recommendations for patients with CKD among future practitioners.
Lenz
Oliver
O
Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, USA. olenz@med.miami.edu
Fornoni
Alessia
A
D000740:Anemia / Q000175:diagnosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology; D002908:Chronic Disease; D002983:Clinical Competence / Q000706:statistics & numerical data; D005194:Family Practice / Q000193:education* / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000209:etiology; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D007388:Internal Medicine / Q000193:education* / Q000706:statistics & numerical data*; D020407:Internet; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D009748:Nutrition Disorders / Q000175:diagnosis / Q000209:etiology; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States / Q000453:epidemiology