[Chronic kidney disease: do generalists and nephrologists differ in their care?].

Abstract

INTRODUCTION:

Chronic kidney disease (CKD) is a major public health problem. We report an evaluation of the CKD perception from a French family physician's (FP) point of view.

METHODS:

A questionnaire was sent to a representative and independently selected sample of 497 FP, i.e. 20% of the FP working in the administrative region Lorraine. There were 214 completed surveys, i.e. response rate: 43%.

RESULTS:

Age of FP was: < 40 years of age: 13%, 40-50: 40%, > 50: 47%. The geographic working place was urban: 41%, rural: 22%, urban and rural: 37%. Ninety-nine per cent of FP has a nephrologist, devoted to CKD referral. Twenty-one per cent of FP has a comprehensive picture of CKD and 75% thinks that CKD diagnostic is difficult Thirty per cent of FP were aware of CKD guidelines. For FP, risk-factors for CKD were: hypertension: 93%, diabetes: 99%, age over 65: 64%, urinary infection: 34%, hematuria/proteinuria: 78%, anaemia: 43%, therapeutics associated with risk of renal injury: 79%, all of these circumstances: 20%. The referral decision to a nephrologist was done at a mean creatinine clearance of 41+/-12 ml/min. Age over 80, dementia, and cancer were considered to be a contra-indication of renal replacement therapy, for respectively 30%, 69%, and 63% of FP. CME was associated with better awareness of guidelines, and use of clearance rather than serum creatinin.

CONCLUSION:

From FP point of view, overall awareness of CKD guidelines is low. In the context of the current nephrology services, greater sharing of CKD care with FP is needed.

• Authors: Luc Frimat, Georges Siewe, Carole Loos-Ayav, Serge Briançon, Michèle Kessler, Alain Aubrège
• Journal: Nephrologie & therapeutique (Nephrol Ther) Vol. 2 Issue 3 Pg. 127-35 (Jul 2006) ISSN: 1769-7255 [Print] France
• Vernacular Title: Insuffisance rénale chronique: connaissances et perception par les médecins généralistes.
• PMID: 16890137 (Publication Type: Comparative Study, English Abstract, Journal Article)

Topics

• Adult
• Demography
• Family Practice
• France
• Humans
• Middle Aged
• Nephrology
• Renal Insufficiency, Chronic (therapy)
• Risk Factors
• Surveys and Questionnaires