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Treatment options for end stage renal disease
Paul W Crawford1, Edgar V Lerma
1Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. pwcmd@yahoo.com
Primary Care
|August 20, 2008
Summary
Kidney disease is rising in aging baby boomers due to increased diabetes and hypertension. Early intervention is crucial to prevent end-stage renal disease and the need for renal replacement therapy.
Area of Science:
- Nephrology
- Public Health
- Geriatrics
Background:
- Increasing incidence of kidney disease observed in aging baby boomers.
- Rising rates of diabetes mellitus and hypertension contribute to kidney disease progression.
- Primary care physicians increasingly manage patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Purpose of the Study:
- To highlight the late referral of CKD patients to nephrologists.
- To emphasize the missed opportunities for secondary preventive interventions.
- To discuss treatment options for patients with ESRD.
Main Methods:
- Review of trends from the National Health and Nutrition Study.
- Analysis of patient referral patterns in primary care.
- Examination of secondary preventive strategies for CKD.
- Overview of current ESRD treatment modalities.
Main Results:
- Significant increase in kidney disease among the aging baby boomer population.
- Delayed nephrology referrals often preclude effective secondary prevention.
- Suboptimal management of CKD may accelerate progression to ESRD.
Conclusions:
- There is an urgent need for earlier identification and management of CKD.
- Primary care physicians play a vital role in timely nephrology referral.
- Timely intervention can potentially delay or prevent the need for renal replacement therapy.
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