The Role of the Family Doctor in the Prevention of Kidney Diseases in the Population in the Management of the Primary Care System

Abstract

The increase in the number of cases of obesity, diabetes and hypertension, along with the aging of the population, lead to a sharp increase in the prevalence of chronic kidney disease (CKD). Despite this increase, most Americans with early-stage CKD are still unaware of their disease. Primary care physicians are at the forefront of efforts to detect CKD early and manage patients to control its progression. Patients with CKD should be referred to nephrologists no later than the moment when their estimated glomerular filtration rate reaches 30 ml/minute. Nephrological examination at this stage is important to facilitate timely preparation for the treatment of end-stage renal failure by preventive transplantation or planned transition to dialysis. In addition to strict control of concomitant hypertension and/or diabetes, mineral metabolism indicators (serum parathyroid hormone, phosphorus, calcium and bicarbonate) should be carefully monitored in patients with progressive CKD, to avoid adverse effects on the cardiovascular and bone systems.