Family Medicine Update

A process for change: a methodology for academic family medicine.

Ann Fam Med. 2008 Nov-Dec;6(6):569-70

Authors: Abercrombie S, Callaway P, Carek P, Carr S, Dickson G, Gravel J, Hall K, Jones S, Kozakowski S, Palmer E, Robinson M, Wieschhaus M

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Common mental disorders in primary care in India: little to distinguish five commonly used screening instruments.

Evid Based Ment Health. 2008 Nov;11(4):107

Authors: Goodyear-Smith FA

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[Chronic kidney disease: novelties and scope of follow-up by the primary care physician.]

Nefrologia. 2008;28(5):113-117

Authors: Sánchez Hernández R

Chronic kidney disease (CKD) is a public health problem worldwide, not only because of the risk of progression to end-stage kidney disease (ESKD) but also because of the high risk of morbidity and mortality, especially from cardiovascular disease. In recent years, the epidemiological relevance of CKD has not only raised the interest of nephrologists, but of other areas of medicine and in particular of primary care. The primary objectives of this presentation are to assess the impact that CKD has had in recent years as an epidemiological problem in the primary care setting and to describe the strategies that will be used to try to address this problem. Knowledge of the most relevant factors affecting kidney function with age, and specifically glomerular filtration rate (GFR), is essential for defining the patient group at most risk of mortality, cardiovascular complications and progression to ESKD, thereby facilitating overall and individualized management of these patients. Fortunately, we already have clarifying consensus guidelines on a national scale to address this problem jointly. CKD in a mortality amplifying factor, not only in patients with cardiovascular disease but also in patients with chronic infections and in cancer patients. In this regard, the new KDIGO guidelines place particular emphasis on the need to assess renal function in these patients and to perform vigorous cardioprotection from the initial stages of CKD.

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