Orte L Maria
Servicio de Nefrología, Hospital Ramón y Cajal, Madrid.
Nefrologia. 2005;25 Suppl 2:87-90.
The Spanish nephrology is one of the medical specialties that have experienced a greater development in the last years. Defined initially as an activity in the hospital and consolidated in this sense, at the present time the "Libro Blanco of the Spanish Nephrology" makes a call of attention on the necessity of a change of welfare direction. The attention was called on the little development of the prevention activities and the delay in the arrival of the patient to the Service of Nephrology, which causes a worsening of his pathology. In order to approach us this reality it is necessary to give priority to the attendance of the patient out of the hospital and to guarantee a logical continuity between welfare levels. The welfare initiatives that have been carried out in the Spanish territory are scarce and still insufficient. The progressive increase in the incidence and prevalence of the ERD associated with a bad evolution and elevated costs is converting ERD in an important problem of public health, that requires specific plans of detection and prevention. The improvement of the coordination between general practioners and nephrologists is necessary. Multiple papers show a delayed reference of the patients with renal disease to the nephrologists. The initiatives of coordination between both levels should be centered in studies epidemiologists that clarify the real meaning of the renal pathology and in educating the GP on the early reference to the nephrologist of the patients with renal failure.
西班牙肾脏病学是近年来发展较为显著的医学专科之一。最初它被定义为医院内的一项业务并在此层面得以巩固，目前《西班牙肾脏病学白皮书》呼吁关注福利方向转变的必要性。人们呼吁关注预防活动开展较少以及患者前往肾脏病科就诊延迟的问题，这会导致其病情恶化。为了让我们了解这一现实情况，有必要优先在院外为患者提供服务，并确保不同福利层面之间的合理连续性。在西班牙境内开展的福利举措稀少且仍不充分。与不良病情发展和高昂成本相关的终末期肾病的发病率和患病率不断上升，这使终末期肾病成为一个重要的公共卫生问题，需要具体的检测和预防计划。改善全科医生和肾脏病医生之间的协调是必要的。多篇论文表明，肾病患者转诊至肾脏病医生的时间有所延迟。两个层面之间的协调举措应聚焦于流行病学研究，以阐明肾脏疾病的真正意义，并对全科医生进行教育，使其能尽早将肾衰竭患者转诊给肾脏病医生。
