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Referring the Preventable Before It Becomes the Inevitable

  • 1 Daniel Edmonston, MD, is a first-year nephrology fellow at Duke University.
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Daniel Edmonston, MD

Despite initiatives to improve access and delivery of preventive care, much of medicine is still reactionary. We wait behind brick-and-mortar walls for our patients to come to us with a list of problems in hand.

The field of nephrology is not immune to this limitation. Arguably, we are among the most susceptible. Like the “silent killer” hypertension, most patients with chronic kidney disease (CKD) are asymptomatic until the disease approaches advanced, often irreversible, levels. This lack of symptoms leads to patient under-recognition of even advanced CKD.

Compounding this problem, provider recognition of CKD may also be lacking

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