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Master Thesis

Adressage au néphrologue dans la maladie rénale chronique : étude descriptive chez les médecins de la SISA des Pays de Nay dans les Pyrénées-Atlantiques

Abstract : Background: chronic kidney disease is a major public health problem which needs to be apprehended early on. The goal of our study was to determine the eGFR rate, the General Practitioners of the SISA of « Pays de Nay », in the Atlantic Pyrenees, referred their patients with chronic kidney disease (CKD) to the nephrologist, and what factors influenced their referral. Method: the descriptive epidemiological study was a practice study by analysis of computerized medical files of the practitioners of the SISA of « Pays de Nay ». The studied files were those of patients with CKD stage 3B or less (eGFR rate < 45 ml/min/1,73m2). Results: general practitioners referred to the nephrologist only 32,81% of their CKD patients (stage 3B or less) with an average eGFR rate of 34,1 ml/min/1,73m2. The factors leading to an earlier referral were : positive proteinuria (p=0,002), elevated potassium levels (p=0,023) (average of 4,81 mmol/L), fast annual eGFR decrease (p=0,003), abnormal blood pressure mesures (p=0,011) and a high level of autonomy (p=0,004). On the other hand, the older the patient, less they were referred (p<0,001), with an average age referral at 77. Conclusion: general practitioners of the SISA have a curative rather than a preventive attitude with CKD patients and nephrological referral. The nephrologist supply being insufficient, additional help in the follow up of these patients, thanks to an ASALEE nurse (present in the SISA) could be considered in primary care.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03464567
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Submitted on : Friday, December 3, 2021 - 12:24:12 PM
Last modification on : Friday, December 17, 2021 - 3:47:06 AM
Long-term archiving on: : Friday, March 4, 2022 - 7:00:01 PM

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Camille Gourrat. Adressage au néphrologue dans la maladie rénale chronique : étude descriptive chez les médecins de la SISA des Pays de Nay dans les Pyrénées-Atlantiques. Médecine humaine et pathologie. 2021. ⟨dumas-03464567⟩

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