title: [Are there differences in the treatment of kidney patients if they are admitted to general medicine vs nephrology units? Yes, and they are significant].
abstract: The care provided by a nephrologist is fundamental because the nephrologist is able to prevent, recognize and treat the many and complex factors of comorbidity inherent in chronic kidney disease at its various stages. The nephrologist also has the important task of delaying the start of dialysis for as long as possible. Delaying dialysis slightly, even just one year for each patient, will have ethical, social and economic advantages that should be duly weighed and carefully evaluated when adopting organizational models of care involving nephrology. The nephrologist bases his work on the clinical competence acquired and maintained through appropriate training programs based on CME courses and, above all, daily clinical practice that, in order to be truly educational, must reach a sufficient volume of activity to guarantee the best possible outcome to the patient.
authors.affiliation: Coordinatore Commissione Organizzazione Servizi Nefrologia, Dialisi e Trapianto della Società Italiana di Nefrologia. quintaliani@yahoo.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Quintaliani
authors.forename: Cristina
authors.initials: C
authors.lastname: Gambirasio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Strippoli
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D019317:Evidence-Based Medicine; D006436:Hemodialysis Units, Hospital / Q000592:standards; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D007388:Internal Medicine / Q000592:standards; D007558:Italy; D007674:Kidney Diseases / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D020380:Needs Assessment / Q000592:standards; D009398:Nephrology / Q000592:standards; D010819:Physician's Role; D011787:Quality of Health Care / Q000592:standards; D006435:Renal Dialysis / Q000592:standards*; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors