TY - JOUR T1 - The role of primary care in managing chronic kidney disease JF - British Journal of General Practice JO - Br J Gen Pract SP - 396 LP - 397 DO - 10.3399/bjgp10X502065 VL - 60 IS - 575 AU - Mark Brady AU - Donal O'Donoghue Y1 - 2010/06/01 UR - http://bjgp.org/content/60/575/396.abstract N2 - Chronic kidney disease (CKD) is common, harmful, and treatable. CKD is now recognised as a public health problem because of its association and interactions with other vascular diseases. Primary care has a pivotal role in educating the public, alongside early identification and integrated management of CKD. Times of crisis offer the best environment and opportunities to change what we do for the better. At the very least, the current financial climate demands improved quality of care for the same money. The NHS has traditionally been poor at measuring quality, yet it is essential to know whether what we do adds value or not, and how to maximise implementation of best practice.Epidemiological studies suggest that up to 10% of the population have CKD1 but some clinicians question the impact and significance of diagnosing a patient with CKD, particularly as the concept of CKD is relatively new and patients with early disease are often asymptomatic. Even individuals with modest reductions in kidney function (estimated glomerular filtration rate 30–44 mL/min/1.73 m2; CKD Stage 3B), have adjusted hazard ratios for death of 1.8 and are twice as likely to suffer cardiovascular events.2 Furthermore, this independent association of CKD with adverse outcomes is graduated, worsening with severity of kidney impairment. Identifying and appropriately managing the 6 million people with CKD in the UK offers real opportunities to improve vascular care, achieve … ER -