Chronic Kidney Disease: A Place for Primary Care and Nephrology to Meet

Excerpt

In this issue of JGIM, Ricardo et al. report findings from the Chronic Renal Insufficiency Cohort (CRIC) study in their manuscript titled ‘Influence of Nephrologist Care on Management and Outcomes in Adults with Chronic Kidney Disease’.1 The authors characterize patterns of nephrology care and examine the association between receipt of nephrology care and guideline-concordant management of chronic kidney disease (CKD) complications and clinical outcomes. The article highlights a number of key issues, including disparities in self-reported receipt of nephrology care. When clinical outcomes were examined, Ricardo et al. found that prior nephrology contact was associated with some guideline-concordant treatments of CKD complications among a subset of patients with CKD stage 4; however, in this population recruited from general medicine and specialty clinics in the U.S., there was no statistically significant association between prior nephrology contact and CKD progression, incident cardiovascular disease (CVD) or death. …