[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-468600-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-468600-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","chronic-kidney-disease-importance-of-early-diagnosis-and-immediate-referral","Chronic Kidney Disease - Importance of Early Diagnosis and Immediate Referral","","Chronic kidney disease (CKD) is defined by persistent reductions in glomerular filtration rate and/or evidence of parenchymal damage lasting at least three months. Even though CKD diagnosis is now relatively straightforward, nephrologist first-contact immediately before dialysis remains unacceptably common. Early diagnosis and prompt referral to nephrology support predialysis education, enable preventive measures that delay or halt progression to end-stage renal disease, and reduce initial morbidity and mortality.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/chronic-kidney-disease-importance-of-early-diagnosis-and-immediate-referral/468600/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/chronic-kidney-disease-importance-of-early-diagnosis-and-immediate-referral/468600.png","ImageObject",300,407,{"name":42,"@type":43},"pop out","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",12,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How is chronic kidney disease (CKD) defined in this review?","Question",{"text":63,"@type":64},"CKD is defined by changes in the glomerular filtration rate and/or the presence of kidney parenchymal damage that persists for at least three months.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Why are early diagnosis and immediate nephrology referral emphasized?",{"text":68,"@type":64},"They enable predialysis education, support preventive measures that delay or even halt CKD progression to end-stage renal disease, and decrease initial morbidity and mortality.",{"name":70,"@type":61,"acceptedAnswer":71},"What are the key components of the CKD diagnostic framework mentioned?",{"text":72,"@type":64},"The framework includes an anatomical/structural component (markers of kidney damage), a functional component (based on GFR), and a temporal component.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},468600,1791133193,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},962090760408,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Review ARticle  \nChronic kidney disease: importance of early diagnosis, immediate referral and structured interdisciplinary approach to improve outcomes in patients not yet on dialysis  \nAuthors  \nMarcus Gomes Bastos1  \nGianna Mastroianni Kirsztajn1  \n1 Universidade Federal de Juiz de Fora (UFJF) e Universidade Federal de São Paulo (Unifesp), Brasil.  \nApproved on: 01/27/2011.  \nCorresponding author:  \nMarcus G. Bastos  \nNIEPEN-UFJF  \nRua José Lourenço Kelmer 1.300  \nSão Pedro  \nJuiz de Fora – MG – Brazil CEP: 36036-330  \nE-mail:  \n[marcusgb@terra.com.br](marcusgb@terra.com.br)  \nThe authors declare no conflict of interest.  \n74  \nAbstrAct  \nAt present, chronic kidney disease (CKD) is broadly defined on the basis of changes in the glomerular filtration rate and/or the presence of parenchymal damage present for at least 3 months. Although the diagnosis of CKD is now quite straightforward, the proportion of patients with endstage renal disease seen by a nephrologist for the first time immediately before the initiation of dialysis is still unacceptable. Early diagnosis and immediate nephrology referral are key steps in management because enable predialysis education, allow implementation of preventive measures that delay or even halt progression of CKD to end stage renal disease, as well as decrease initial morbidity and mortality. In this review, we discuss the complexity of CKD and the multiplicity of interventions currently recommended in its secondary prevention, different models of healthcare delivery, and examine the rational and outcomes of patients followed in interdisciplinary care clinics.  \nKeywords: chronic kidney disease, chronic kidney failure, referral and consultation, early diagnosis, glomerular filtration rate, proteinuria, interdisciplinary care model.[J Bras Nefrol 2011;33(1): 74-87]©Elsevier Editora Ltda.  \nIntroductIon  \nNephrology has experienced major changes since its inception in the early 1960s, when it emerged as a medical specialty. Initially, the focus of nephrology was renal replacement therapy (RRT), namely, dialysis and kidney transplantation, which became an established form of treatment for patients who had progressed to endstage renal disease (ESRD) . In Brazil during this early period, several RRT  \nprograms were created in both the public and private health systems. Nephrology in Brazil also quickly reached international levels of excellence. However, during this early period, very little attention was paid to preventive measures that preserve the glomerular filtration rate (GFR) .  \nThe last decade has revealed that the progression of chronic kidney disease (CKD) in patients with different renal pathologies who are under the nephrological care can be delayed or even halted by various measures. These include the strict control of blood pressure and the use of drugs that block the renin-angiotensinaldosterone system (RAAS) .1 In addition, several epidemiological studies on groups of patients at risk of developing CKD, published in the last decade, have shown that the prevalence of CKD is much higher than previously thought.1 Indeed, CKDis now considered as the great epidemic of this millennium. These observations have caught the attention of the international and the Brazilian nephrology communities, which are now starting to take various measures to manage the problem.  \nEpIdEmIology of chronIc kIdnEy dIsEAsE  \nCKD has received increased attention from the international scientific community since recent studies showed its high prevalence. Of particular significance is the cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of non-institutionalized adults aged 20 years or older,(n= 13,233) which was conducted between 1999 and 2004. CKD prevalence was determined based on persistent albuminuria (>30 mg/g)  \nand decreased estimated GFR using the abbreviated Modification of Diet in Renal Disease Study (MDRD) equation reexpre","cbCaimqn47dw1Z2p","https://ap.wps.com/l/cbCaimqn47dw1Z2p","pdf",390719,14,"English","# Introduction\n## Epidemiology of Chronic Kidney Disease\n## Definition of Chronic Kidney Disease\n## Early Diagnosis, Immediate Referral, and Interdisciplinary Care\n## Secondary Prevention and Care Models","[{\"question\":\"How is chronic kidney disease (CKD) defined in this review?\",\"answer\":\"CKD is defined by changes in the glomerular filtration rate and/or the presence of kidney parenchymal damage that persists for at least three months.\"},{\"question\":\"Why are early diagnosis and immediate nephrology referral emphasized?\",\"answer\":\"They enable predialysis education, support preventive measures that delay or even halt CKD progression to end-stage renal disease, and decrease initial morbidity and mortality.\"},{\"question\":\"What are the key components of the CKD diagnostic framework mentioned?\",\"answer\":\"The framework includes an anatomical/structural component (markers of kidney damage), a functional component (based on GFR), and a temporal component.\"}]","Chronic Kidney Disease - Importance of Early Diagnosis and Immediate Referral | PDF",1790774443,35]