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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© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
