title: [Who is the physician in charge with the primary care of the dialysis patients?].
abstract: BACKGROUND
  The role played by nephrologists in hemodialysis patients' primary care is not well known. We hypothesized that primary care are provided by nephrologists and not by general practitioners for most of these patients. The aim of this study was to estimate the rate of hemodialysis patients having a nephrologist as primary care provider, and to determine which factors were associated with non-resort to a general practitioner for primary care.
  
  
  METHODS
  Patients older than 18 years treated by hemodialysis for more than 3 months in the Calvados district were included and were interviewed with a standardized questionnaire. A log-binomial regression was used to study factors associated with non-resort to a general practitioner for primary care.
  
  
  RESULTS
  Only 26% of patients had a general practitioner involved in the primary care; whereas 47% considered that nephrologists were the physician in charge of the primary care. Time spent in hemodialysis was associated with non-resort to a general practitioner, while patients living in nursing home were more likely to have regularly a regular follow up by a general practitioner. Dialysis center was a factor associated with the general practitioner as a primary care provider.
  
  
  CONCLUSIONS
  Primary care of the hemodialysis patient is provided by nephrologists.
authors.affiliation: Service de néphrologie, CHU Clémenceau, 14033 Caen cedex, France.
authors.forename: Clémence
authors.initials: C
authors.lastname: Béchade
authors.affiliation: Service de médecine générale, CHU Côte-de-Nacre, 14033 Caen cedex, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Daireaux
authors.affiliation: Service de néphrologie, CHU Clémenceau, 14033 Caen cedex, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Henri
authors.affiliation: Service de néphrologie, centre hospitalier général Bisson, 14100 Lisieux, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Landru
authors.affiliation: Service de néphrologie, centre hospitalier privé Saint-Martin, 14000 Caen, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Batho
authors.affiliation: Service de néphrologie, CHU Clémenceau, 14033 Caen cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hurault de Ligny
authors.affiliation: Service de néphrologie, CHU Clémenceau, 14033 Caen cedex, France. Electronic address: lobbedez-t@chu-caen.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lobbedez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009398:Nephrology; D010819:Physician's Role; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: General practitioner; Hemodialysis; Hémodialyse; Médecin généraliste; Nephrologists; Néphrologues; Primary care; Soins primaires