Bauer Andrea Carla, Elias Rosilene M, Abensur Hugo, Batista Marcelo Costa, Jansen Angela Marie, Riella Miguel Carlos
Department of Internal Medicine- Nephrology Division, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Nephrology Division, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.
Kidney Dis (Basel). 2024 Feb 29;10(3):213-223. doi: 10.1159/000538068. eCollection 2024 Jun.
Over the last 3 decades, over 700 million individuals worldwide have been diagnosed with chronic kidney disease (CKD). In a 2017 survey in southern Brazil, 11.4% of those surveyed had CKD. Early identification and effective therapy in Brazil may reduce CKD's impact. This panel discusses the early diagnosis and treatment of CKD and the barriers and actions needed to improve the management of CKD in Brazil. A panel of Brazilian nephrologists was provided with relevant questions to address before a multiday conference. During this meeting, each narrative was discussed and edited through several rounds until agreement on the relevant topics and recommendations was achieved.
Panelists highlighted hurdles to early diagnosis and treatment of CKD. These include, but are not limited to, a lack of public and patient education, updated recommendations, multidisciplinary CKD treatment, and a national CKD database. People-centered, physician-centered, and healthcare institution-centered actions can be taken to improve outcomes. Patient empowerment is needed via multiple channels of CKD education and access to health-monitoring wearables and apps. Primary care clinicians and nonspecialists must be trained to screen and manage CKD-causing illnesses, including diabetes and hypertension. The healthcare system may implement a national health data gathering system, more screening tests, automated test result reporting, and telehealth.
Increasing access to early diagnosis can provide a path to improving care for patients with CKD. Concerted efforts from all stakeholders are needed to overcome the barriers.
在过去30年里，全球超过7亿人被诊断患有慢性肾脏病（CKD）。在2017年巴西南部的一项调查中，11.4%的受访者患有CKD。在巴西进行早期识别和有效治疗可能会降低CKD的影响。该小组讨论了CKD的早期诊断和治疗以及在巴西改善CKD管理所需克服的障碍和采取的行动。在一次多日会议之前，向一组巴西肾脏病专家提供了相关问题以供讨论。在这次会议期间，每个叙述都经过了几轮讨论和编辑，直到就相关主题和建议达成一致。
小组成员强调了CKD早期诊断和治疗的障碍。这些障碍包括但不限于缺乏公众和患者教育、最新建议、多学科CKD治疗以及国家CKD数据库。可以采取以患者为中心、以医生为中心和以医疗机构为中心的行动来改善治疗效果。需要通过多种CKD教育渠道以及提供健康监测可穿戴设备和应用程序来增强患者能力。必须对初级保健临床医生和非专科医生进行培训，以便筛查和管理导致CKD的疾病，包括糖尿病和高血压。医疗系统可以实施国家健康数据收集系统、更多筛查测试、自动测试结果报告以及远程医疗。
增加早期诊断的可及性可为改善CKD患者的护理提供途径。需要所有利益相关者共同努力来克服这些障碍。
