The aim of the study was to investigate the prevalence for high-risk factors for chronic kidney disease among patients in primary health care centers and to assess diagnostic strategy carried out by family doctors.
Results: We analyzed case records (n=4082) of patients aged more than 18 years in four family doctor's practices of Kaunas city. The ratio of female to male was 1.4:1. The major risk factors for chronic kidney disease (severe hypertension, diabetes, kidney diseases, and severe ischemic diseases) were identified in 458 patients: 287 (62.66%) women and 171 (37.34%) men. It accounted for 11.2% of all patients. They were significantly older as compared to all patients (66.96+/-14.34 vs. 49.86+/-18.54 years, P<0.0001). The most common risk factors were as follows: hypertension (62.66%), primary kidney diseases (33.84%), diabetes (20.96%), and complicated ischemic disease (6.11%). Of the 458 patients, 366 (79.9%) had one and the remaining patients had several risk factors. During the last 24 months, family doctor evaluated kidney function and urinanalysis in 24.4% and 53.6% of patients with high-risk factors, respectively. While examining these patients (n=91), it was determined that even in 54.95% of them, glomerular filtration rate was lower than 60 mL/min/1.73 m2.
Conclusions: The major risk factors for chronic kidney disease were identified in 11.2% of patients from primary health care centers. Most of them were older than 75 years. The most common risk factor was arterial hypertension. The assessment of kidney function in these patients by family doctor was insufficient. A thorough examination of the patients with major risk factors revealed chronic kidney insufficiency in half of them.