JOURNAL ARTICLE

[Non-dialysis chronic kidney disease in primary care - a questionnaire study among general practitioners]

Paul Voigt, Paul Kairys, Anne Voigt, Thomas Frese
Deutsche Medizinische Wochenschrift 2021 January 21
33477172

BACKGROUND:  The majority of patients with non-dialysis chronic kidney disease are cared for by general practitioners. Especially for Germany, the evidence of this topic is still very low. The aim of the survey was to estimate the perceived frequency of non-dialysis chronic kidney disease in general practice, the use of diagnostics and therapy, used tools considering the professional background and experience of the responding general practitioners.

METHODS:  A questionnaire was self-designed in the cooperation of several disciplines. 1130 general practitioners from Saxony and Saxony-Anhalt were randomly selected and the questionnaire was sent by post. Data were collected from June 2019 to July 2019.

RESULTS:  Of the 1,130 questionnaires sent, 372 returned analysable (response rate: 32.9 %). The prevalence of non-dialysis chronic kidney disease was estimated to be 6-15 %. 97 % of the general practitioners rated the adjustment of high blood pressure and diabetes mellitus as a high to very high priority. Concerning the diagnosis of proteinuria, the use of a urine dipstick test was stated by 60.8 % of the respondents and the requirement for an albumin/creatinine-ratio was stated by 22.6 %. Only a few differences could be revealed in the response behavior of the participating groups of doctors. Working experience is an important factor in choosing tools, especially guidelines.

CONCLUSIONS:  The results showed that the doctors interviewed followed international recommendations for the care of patients with non-dialysis chronic kidney disease. However, improvements in progression diagnostics are necessary and important. General practitioners and internal medicines working as general practitioners have a comparable level of competence in the primary medical care of the non-dialysis chronic kidney disease. Significant differences were created by the professional experience of the doctors.

KEY POINTS:   · General practitioners estimate the prevalence of non-dialysis chronic kidney disease in their practice at 6-15 %.. · Using the albumin/creatinine-ratio for proteinuria diagnostics is requested too rarely compared to the urine dipstick test.. · General practitioners, specialists in general medicine and internists working in general medicine have a comparable level of competence to treat patients with non-dialysis chronic kidney disease.. · Working experience is an important factor in choosing tools, especially guidelines..

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