Voigt Paul, Kairys Paul, Voigt Anne, Frese Thomas
Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Dtsch Med Wochenschr. 2021 Mar;146(6):e39-e46. doi: 10.1055/a-1334-2513. Epub 2021 Jan 21.
The majority of patients with non-dialysis chronic kidney disease are cared for by general practitioners. Especially for Germany, the evidence of this topic is still very low. The aim of the survey was to estimate the perceived frequency of non-dialysis chronic kidney disease in general practice, the use of diagnostics and therapy, used tools considering the professional background and experience of the responding general practitioners.
A questionnaire was self-designed in the cooperation of several disciplines. 1130 general practitioners from Saxony and Saxony-Anhalt were randomly selected and the questionnaire was sent by post. Data were collected from June 2019 to July 2019.
Of the 1,130 questionnaires sent, 372 returned analysable (response rate: 32.9 %). The prevalence of non-dialysis chronic kidney disease was estimated to be 6-15 %. 97 % of the general practitioners rated the adjustment of high blood pressure and diabetes mellitus as a high to very high priority. Concerning the diagnosis of proteinuria, the use of a urine dipstick test was stated by 60.8 % of the respondents and the requirement for an albumin/creatinine-ratio was stated by 22.6 %. Only a few differences could be revealed in the response behavior of the participating groups of doctors. Working experience is an important factor in choosing tools, especially guidelines.
The results showed that the doctors interviewed followed international recommendations for the care of patients with non-dialysis chronic kidney disease. However, improvements in progression diagnostics are necessary and important. General practitioners and internal medicines working as general practitioners have a comparable level of competence in the primary medical care of the non-dialysis chronic kidney disease. Significant differences were created by the professional experience of the doctors.
· General practitioners estimate the prevalence of non-dialysis chronic kidney disease in their practice at 6-15 %.. · Using the albumin/creatinine-ratio for proteinuria diagnostics is requested too rarely compared to the urine dipstick test.. · General practitioners, specialists in general medicine and internists working in general medicine have a comparable level of competence to treat patients with non-dialysis chronic kidney disease.. · Working experience is an important factor in choosing tools, especially guidelines..
大多数非透析慢性肾脏病患者由全科医生负责照料。尤其是在德国，关于这一主题的证据仍然非常有限。该调查的目的是估计全科医疗中感知到的非透析慢性肾脏病的发病率、诊断和治疗的使用情况，以及考虑到回复问卷的全科医生的专业背景和经验所使用的工具。
多学科合作自行设计了一份问卷。从萨克森州和萨克森 - 安哈尔特州随机抽取了1130名全科医生，并通过邮寄方式发送问卷。数据收集时间为2019年6月至2019年7月。
在发送的1130份问卷中，有372份返回且可分析（回复率：32.9%）。非透析慢性肾脏病的患病率估计为6% - 15%。97%的全科医生将高血压和糖尿病的调整视为高到非常高的优先事项。关于蛋白尿的诊断，60.8%的受访者表示使用尿试纸条检测，22.6%的受访者表示需要检测白蛋白/肌酐比值。在参与调查的医生群体的回复行为中仅发现了一些差异。工作经验是选择工具（尤其是指南）的一个重要因素。
结果表明，接受访谈的医生遵循了国际上对非透析慢性肾脏病患者护理的建议。然而，改进病情进展诊断是必要且重要的。全科医生和从事全科医疗工作的内科医生在非透析慢性肾脏病的初级医疗护理方面具有相当的能力水平。医生的专业经验造成了显著差异。
· 全科医生估计他们所诊治的非透析慢性肾脏病患病率为6% - 15%。· 与尿试纸条检测相比，很少有人要求使用白蛋白/肌酐比值进行蛋白尿诊断。· 全科医生、普通内科专家和从事普通内科工作的内科医生在治疗非透析慢性肾脏病患者方面具有相当的能力水平。· 工作经验是选择工具（尤其是指南）的一个重要因素。
