The role of the primary care physician in managing early stages of chronic kidney disease

George N. Coritsidis, Ellena Linden, Aaron S. Stern

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Recent increases in obesity, diabetes, and hypertension, along with the aging of the US population, are driving a dramatic rise in the prevalence of chronic kidney disease (CKD). Despite this increase, the majority of Americans with early-stage CKD remain unaware of their disease. Primary care physicians are at the forefront of efforts for early recognition of CKD and management to control its progression. Patients with CKD should be referred to nephrologists no later than the point at which their estimated glomerular fi ltration rate reaches 30 mL/ min. Nephrology evaluation at this point is essential to facilitate timely preparation for care of end-stage renal disease through preemptive transplantation or planned transition to dialysis. In addition to stringent control of underlying hypertension and/or diabetes, mineral metabolic parameters (serum parathyroid hormone, phosphorus, calcium, and bicarbonate) in patients with advancing CKD should be managed closely to avoid adverse effects on the cardiovascular and skeletal systems.

Original languageEnglish
Pages (from-to)177-185
Number of pages9
JournalPostgraduate Medicine
Volume123
Issue number5
DOIs
StatePublished - Sep 2011

Keywords

  • Chronic kidney disease
  • Chronic kidney disease mineral and bone disorder
  • Diabetes
  • Estimated glomerular fi ltration rate
  • Hypertension

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