CHRONIC KIDNEY DISEASE (CKD)
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CKD for Primary Care Physicians
What does a busy doctor want to know about kidney disease?
- Definition and classification?
- The intrinsics of kidney disease
- Why the incidence changed - NHANES III meets MDRD
- Why “kidney”
- What happened to the creatinine clearance?
- What the trends in care are?
- prevention through blood pressure, diabetes and ARB
- Drugs which harm the kidney
- Drugs which harm the body in kidney disease
- Lifestyle changes - exercise, BMI, diet
- Inflammation - CRP
- vitamin D - emerging
- What is the evidence?
- HOPE, MICROHOPE, MRFIT
- ALLHAT, AASK
- ABCD, DCCT, Collaborative Study Group, RENAAL, IRMA
- SysEUR, REIN,
- What are the guidelines?
- NKF KDOQI
- JNC VII
- ADA, AHA,
- Why refer patients to disease management?
- Structured to provide patient support
- Implementation of knowledge the biggest challenge
- Primary physician role is expanded as patient motivation increases
- Nephrologist as coach to primary physician who coaches patient
- Nurse specialists, dietitians, PAs, RNs as trainers
- Continued reinforcement crucial to any lifestyle change