Chronic kidney disease: detect, diagnose, disclose-a UK primary care perspective of barriers and enablers to effective kidney care.
Drawing on a UK primary care perspective, this work frames effective chronic kidney disease (CKD) care around detecting, diagnosing, and disclosing the condition, and examines the practical barriers and enablers that influence whether at-risk patients are identified and managed in primary care.
Background
Chronic kidney disease is common and frequently asymptomatic in its early stages, so many people remain unaware they are living with the condition. Because most patients with CKD risk factors such as diabetes and hypertension are managed in primary care, primary care providers are central to early identification, diagnosis, and management that can slow or prevent disease progression.
Key recommendations
Effective CKD care depends on detecting at-risk individuals through estimated glomerular filtration rate and urine albumin-to-creatinine ratio testing, formally diagnosing and coding the condition, and clearly disclosing it to patients to support shared decision-making and treatment. The broader literature consistently identifies enablers including supportive technology and clinical decision tools integrated into electronic health records, collaborative multidisciplinary teamwork, and primary care-nephrology coordination.
Clinical implications
Commonly reported barriers to CKD detection and management in primary care include limited clinician time, gaps in awareness or knowledge, reluctance to disclose a diagnosis, and communication challenges with patients. Addressing these through education, harmonized guidelines and pathways, automated detection within practice systems, and clear, supportive patient communication may improve the proportion of patients who are appropriately identified, diagnosed, and treated.
Category
Research
Source
BMC Med
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