[Nephrology in general practice]

Hints for the practitioner concerning the management of patients with renal disease are presented. Important facts relating to history, physical, laboratory and radiological findings are stressed and diagnostic assessment is briefly described. Although the general practitioner will refer such patients in most instances to a nephrologist, he should know what kind of further examinations and studies are necessary for correct diagnosis and adequate treatment. The present therapeutic possibilities have greatly improved, but one still disappointing aspect is the treatment of certain forms of glomerulonephritis. The cumulative survival rates in patients undergoing hemodialysis and renal transplantation are assessed and compared with the survival rates in patients suffering from myocardial infarct and carcinoma of the breast, colon and the lung. Essential preventive measures are avoidance of toxic substances like analgesics and consistent antihypertensive therapy even in patients with a renal ailment. The dosage of drugs which are mainly eliminated by the kidneys must be adapted to renal function (serum creatinine or clearance of endogenous creatinine).