[Who is the physician in charge with the primary care of the dialysis patients?]

Abstract

Introduction: The role played by nephrologists in hemodialysis patients' primary care is not well known. We hypothesized that primary care are provided by nephrologists and not by general practitioners for most of these patients. The aim of this study was to estimate the rate of hemodialysis patients having a nephrologist as primary care provider, and to determine which factors were associated with non-resort to a general practitioner for primary care.

Methods: Patients older than 18 years treated by hemodialysis for more than 3 months in the Calvados district were included and were interviewed with a standardized questionnaire. A log-binomial regression was used to study factors associated with non-resort to a general practitioner for primary care.

Results: Only 26% of patients had a general practitioner involved in the primary care; whereas 47% considered that nephrologists were the physician in charge of the primary care. Time spent in hemodialysis was associated with non-resort to a general practitioner, while patients living in nursing home were more likely to have regularly a regular follow up by a general practitioner. Dialysis center was a factor associated with the general practitioner as a primary care provider.

Conclusion: Primary care of the hemodialysis patient is provided by nephrologists.

Keywords: General practitioner; Hemodialysis; Hémodialyse; Médecin généraliste; Nephrologists; Néphrologues; Primary care; Soins primaires.