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Early chronic kidney disease: diagnosis, management and models of care

Wouters, Olivier J., O'Donoghue, Donal J., Ritchie, James, Kanavos, Panos G. and Narva, Andrew S. (2015) Early chronic kidney disease: diagnosis, management and models of care. Nature Reviews Nephrology, 11 (8). pp. 491-502. ISSN 1759-5061

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Identification Number: 10.1038/nrneph.2015.85

Abstract

Chronic kidney disease (CKD) is prevalent in many countries, and the costs associated with the care of patients with end-stage renal disease (ESRD) are estimated to exceed US$1 trillion globally. The clinical and economic rationale for the design of timely and appropriate health system responses to limit the progression of CKD to ESRD is clear. Clinical care might improve if early-stage CKD with risk of progression to ESRD is differentiated from early-stage CKD that is unlikely to advance. The diagnostic tests that are currently used for CKD exhibit key limitations; therefore, additional research is required to increase awareness of the risk factors for CKD progression. Systems modelling can be used to evaluate the impact of different care models on CKD outcomes and costs. The US Indian Health Service has demonstrated that an integrated, system-wide approach can produce notable benefits on cardiovascular and renal health outcomes. Economic and clinical improvements might, therefore, be possible if CKD is reconceptualized as a part of primary care. This Review discusses which early CKD interventions are appropriate, the optimum time to provide clinical care, and the most suitable model of care to adopt.

Item Type: Article
Official URL: http://www.nature.com/nrneph/index.html
Additional Information: © 2015 Nature Publishing Group
Divisions: Social Policy
LSE Health
Subjects: R Medicine > RM Therapeutics. Pharmacology
R Medicine > RZ Other systems of medicine
Sets: Departments > Social Policy
Research centres and groups > LSE Health and Social Care
Research centres and groups > LSE Health
Research centres and groups > LSE Enterprise
Date Deposited: 10 Jun 2015 16:19
Last Modified: 20 Sep 2019 02:01
URI: http://eprints.lse.ac.uk/id/eprint/62287

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