Nationwide questionnaire survey on collaboration for the management of chronic kidney disease from the perspective of referrals in Japan.

BACKGROUND

Preventing end-stage renal failure progression of patients with chronic kidney disease (CKD) requires collaboration between nephrologists and general practitioners. Following the 2013 and 2019 surveys in Japan, a nationwide survey was conducted in 2024 to clarify collaborations for CKD management.

METHODS

An anonymous survey comprising CKD collaboration-related questions was conducted in 2024 among Japan Physicians Association members. In addition to comparing the results with past survey findings, responses were compared between those who refer and referral recipients.

RESULTS

Overall, 1,003 valid responses were obtained. Compared with previous surveys, the 2024 survey revealed a higher number of nephrologists with whom patients could consult (p < 0.001); however, the prevalence of respondents who answered that CKD collaboration was adequately active did not increase. The proportion of respondents who often used the CKD consultation referral criteria was lower in the 2024 survey than in the 2019 survey (p < 0.001). Furthermore, there were discrepancies in the estimated glomerular filtration rate and proteinuria at referral between respondents who referred and referral recipients (p < 0.001). Satisfaction regarding CKD referrals had not improved over the past decade, and the most frequent dissatisfaction causes among respondents who refer and referral recipients were no change in CKD treatment and late referrals, respectively. Many respondents answered that salt reduction guidance and management of blood pressure and glycemic control should be provided by general practitioners.

CONCLUSION

Regional CKD management-related collaboration has not necessarily progressed, and there are discrepancies in CKD management between nephrologists and general practitioners.