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Analysis of Multidisciplinary Care Models and Interface With Primary Care in Management of Chronic Kidney Disease

  • Monica Beaulieu
    Correspondence
    Address reprint requests to Monica Beaulieu, MD, FRCPC, 1081 Burrard St, Room 6010A, Providence Wing, St Paul's Hospital, Vancouver, British Columbia, Canada V6Z1Y8
    Affiliations
    Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada, and Providence Health Care/St Paul's Hospital, Vancouver, British Columbia, Canada
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  • Adeera Levin
    Affiliations
    Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada, and Providence Health Care/St Paul's Hospital, Vancouver, British Columbia, Canada
    Search for articles by this author

      Summary

      Public policy efforts and education have led to an increased appreciation of the prevalence of chronic kidney disease (CKD) in general outpatient populations. The complexity of the care of individuals with established CKD has led to the development of multidisciplinary care models, which have been shown to improve the clinical outcomes of those with CKD. The interface between specialty and primary care in various systems remains necessary and desired, albeit a continuing challenge. This overview reviews various models of specialty care for CKD patients, including those that emphasize multidisciplinary team approaches, and highlight the essential role(s) of primary care physicians. Importantly, there is a need for improved definition of CKD populations and individuals, review and refinement of proposed care pathways, and the need to define essential elements of care for the patient. Models of care often are not subject to the same rigor that other interventions applied to this population are; nonetheless, we offer here a framework for establishing and evaluating care models for the CKD populations at various stages of disease and with various comorbidities.

      Keywords

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