The nephrologist as primary care clinician in patients with end-stage renal disease
- Jean L Holley, MD, FACP
Jean L Holley, MD, FACP
- Clinical Professor of Medicine
- University of Illinois, Urbana-Champaign
The practice of nephrology encompasses both primary and specialty medical care. Consultative care is primarily given to patients with newly diagnosed kidney disease, including acute renal failure or acute kidney injury, hematuria, or proteinuria. Nephrologists also commonly provide primary care or nonrenal related medical care to patients undergoing chronic dialysis. As an example, the initial evaluation of chest pain in the dialysis patient is most often performed by the nephrologist who also oversees renal replacement therapy.
Factors involved in the debate over primary care provided by a nephrologist include [1-10]:
●The time and training required for primary care
●The lack of adequate reimbursement for nondialysis-related care
●The projected lack of available nephrologists
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