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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Reducing CKD risks among vulnerable populations in primary care.

Raquel Greer1, L Ebony Boulware1

  • 1Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, MD; and Division of General Internal Medicine, Duke University School of Medicine, Durham, NC.

Advances in Chronic Kidney Disease
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PubMed
Summary

High-quality primary care can reduce chronic kidney disease (CKD) disparities. Team-based approaches within the Chronic Care Model show promise for improving CKD risk in vulnerable populations.

Keywords:
Chronic kidney diseaseHealth-care disparitiesPrimary careQuality improvementSocioeconomic status

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Area of Science:

  • Health Services Research
  • Public Health
  • Nephrology

Background:

  • Ethnic/racial and socioeconomic status disparities in chronic kidney disease (CKD) outcomes are widespread.
  • Primary care settings are central to managing CKD risk and progression.
  • Addressing disparities in CKD requires high-quality primary care interventions.

Purpose of the Study:

  • To evaluate the effectiveness of the Chronic Care Model in reducing CKD disparities.
  • To identify key components of the Chronic Care Model that impact CKD risk and outcomes in vulnerable populations.
  • To highlight the need for further research on strategies to eliminate CKD disparities.

Main Methods:

  • Review of evidence on Chronic Care Model constructs in primary care.
  • Analysis of the impact of team-based care, case management, and community health workers on CKD risks.
  • Examination of the effects of clinical information systems, decision support, and patient-centered care on CKD processes and outcomes.

Main Results:

  • Team-based approaches within the Chronic Care Model show effectiveness in modifying CKD risks for ethnic minority and low-income patients.
  • Clinical information systems and patient-centered care interventions have mixed or limited effects on patient outcomes.
  • Few studies have specifically assessed the impact of these strategies on reducing health disparities.

Conclusions:

  • The Chronic Care Model offers a framework for improving primary care for CKD.
  • Team-based care strategies show potential for reducing CKD disparities.
  • Further research is crucial to determine the effectiveness of these strategies in eliminating CKD disparities among vulnerable groups.