ArticleJornal brasileiro de nefrologia
Patients with chronic kidney disease stage 3b: do general practitioners and nephrologists follow KDIGO guidelines?
Article in Jornal brasileiro de nefrologia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Brazil between guidelines and reality: the challenges of chronic kidney disease care in Brazil.Jornal brasileiro de nefrologiaArticle
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4 authors.
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Abstract
backgroundAppropriate referral and management of patients with chronic kidney disease (CKD) from primary care to nephrologists are essential to prevent disease progression and complications.
objectivesTo describe the demographic and follow-up characteristics of patients with CKD stage 3b at the time of nephrology referral, the medical care offered by general practitioners, and the initial care provided by nephrologists in the Brazilian Unified Health System (SUS).
methodsThis retrospective cohort study included all patients with CKD stage 3b on the waiting list for nephrology consultation between January 2018 and January 2020 in a large city in southern Brazil. Sociodemographic data, comorbidities, and adherence to follow-up recommendations based on the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were analyzed. Laboratory test requests and results were compared between the periods of general practitioner care and the period following nephrology consultation.
resultsA total of 211 patients (mean age 74 ± 12 years) were included; 76.0% were hypertensive and 46.9% had diabetes. Approximately half had an adequate number of primary care appointments. Laboratory monitoring was suboptimal in both primary and specialized care. Before nephrology consultation, hemoglobin and urinalysis were available for 32.2% and 19.4% of patients, respectively. After consultation, hemoglobin and potassium results were documented in 68.3% and 58.8% of patients, respectively.
conclusionAlthough patients with CKD stage 3b were regularly followed, low adherence to KDIGO testing recommendations raises concerns about the adequacy of care. Strengthening communication and guideline implementation between primary care and nephrology services is crucial to improve CKD management within the SUS.
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