Management of chronic kidney disease: primary health-care setting, self-care and multidisciplinary approach

Condições clínicas e comportamento de procura de cuidados de saúde pelo paciente renal crônico

“…This signals the risk this situation causes with regard to the morbidity and mortality and the costs related to the complications deriving from inappropriate conducts. (4)(5)(6) Due to the absence of symptoms in the initial stages of the disease, the health professionals always need to maintain suspicious, mainly in patients with risk factors. This early diagnostic difficulty hampers the opportunity to implement prevention measures, partially due to the lack of knowledge about the definition and classification of the disease stages and the non-use of simple tests for its diagnosis and functional assessment.…”

“…At the high complexity level, the access to and quality of the dialysis process needs to be guaranteed with a view to achieving a positive impact on survival, morbidity and quality of life. (6) It is considered important to know the factors present on the therapeutic itineraries of patients demanding health care, which influence the form of coping with the disease diagnosis as well as with the prescribed treatment. Knowing the itinerary allows to us apprehend the interference of the scenario and of the team's approach and posture in client care.…”

“…(4) Brazil has important prevalence and incidence levels of patients under renal replacement therapy, and hypertensive, diabetic and obese patients are considered risk groups for the development of chronic renal disease. (5,6) Although the National Primary Health Care Policy considers that all health professionals are responsible for guaranteeing holistic care delivery, highlighting the prevention of problems, a gap remains between the primary and secondary care levels, as obstacles remain for user access which can compromise the comprehensiveness of care. (5) At the medium complexity level, specialized diagnostic and therapeutic care is expected, guaranteed based on the referral and counter-referral process of arterial hypertension, diabetes mellitus and kidney disease patients.…”

Effects of ambulatory self-control on renal function and electrolyte metabolism in patients with severe heart failure

“…Мы не нашли данных россий-ских исследований, оценивающих состояние функ-ции почек при использовании стратегий терапевти-ческого обучения и самоконтроля у больных ХСН. Среди зарубежных источников нами найдены результаты одного исследования [14], в котором изучался мультидисциплинарный подход с использо-ванием стратегии самоконтроля у больных с высоким риском развития ХБП (ожирение/артериальная гипертензия/сахарный диабет 2 типа). Авторы иссле-дования показали возможность достоверного увели-чения СКФ у больных за счет использования тера-певтического обучения и амбулаторного самокон-троля.…”

Type 2 Translational Research for CKD

“…However, previous studies have demonstrated poor RRT preparation, including inadequate management of CKD-related comorbid conditions (e.g., hypertension and anemia), use of temporary catheter vascular access, and urgent dialysis initiation (57,58). Evidence suggests that early, shared, and informed decision-making among patients, families, and health care providers about preparation for RRT initiation may improve patient outcomes, including management of BP and anemia, use of permanent vascular access at RRT initiation, and selection of RRT modalities consistent with patients' values (59)(60)(61)(62).…”