[The value of early referral in the management of chronic kidney disease: NephroCare's eight years of interaction with general practitioners].
It has been demonstrated that early diagnosis of chronic kidney disease (CKD) is important in containing the morbidity and mortality of this disease. It postpones the initiation of hemodialysis treatment and reduces the risk of complications. General practitioners (GPs) have a relevant part in this process because they are the first point of contact for persons in risk categories (e.g., diabetic and hypertensive patients). In 2002 NephroCare started a collaboration with GPs in the Italian region of Campania. This program, called Nephro Day, is aimed at screening patients with hypertension and diabetes, and identifying patients with CKD to reduce the late referral phenomenon. Meetings between GPs and Nephrocare nephrologists were held in which the etiology, pathology and risk factors associated with CKD as well as the screening options were discussed. Strong emphasis was placed on the importance of assigning CKD patients with hypertension and diabetes to 1 of the 5 stages of the DOQI guidelines. A clear positive correlation was observed between the age of diabetic and hypertensive patients and the risk of CKD. In the current situation of limited budgets and a limited number of nephrologists, the collaboration between GPs and specialists offers an unique opportunity to handle the problem of late referral, allowing timelier and more adequate treatment of patients with CKD and thus leading to substantial cost savings.
NephroCare, Italy. attilio.dibenedetto@fmc-ag.com
Attilio
A
Di Benedetto
Daniele
D
Marcelli
Fabrizio
F
Cerino
Guido
G
Giordana
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D058006:General Practice; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D013997:Time Factors; D055815:Young Adult