Nationwide questionnaire analysis on awareness of general practitioners for the management of chronic kidney disease in Japan.

BACKGROUND

Effectively managing a large numbers chronic kidney disease (CKD) cases requires collaboration between nephrologists and non-nephrologists. In 2024, the Japan physicians association conducted a third nationwide questionnaire survey on managing CKD. This study aimed to clarify the differences in managing CKD between nephrologists and non-nephrologists and identify remaining issues by comparing them with past surveys.

METHOD: In the 2024 surveys, 1003 general practitioners voluntarily participated and answered 20 questions about CKD care and treatment. They were divided into 2 groups: 835 non-nephrologists and 168 nephrologists, and the differences were analyzed. Furthermore, the 2024 survey results were compared with those from the 2013 and 2019 surveys.

RESULTS

The use of CKD guidelines was significantly lower among non-nephrologists than nephrologists (55%/21% and 86%/60%, respectively; p < 0.001), and as in the past 2 surveys (p < 0.001). Estimated glomerular filtration rate assessment was widespread at 95%; nevertheless, 34% of non-nephrologists measured quantitative proteinuria compared to 82% of nephrologists (p < 0.001). This prevalence decreased with each survey and with the age of the non-nephrologists. While 75% of nephrologists prescribed renin-angiotensin system inhibitors for patients with CKD and hypertension, considering their renoprotective effects, 45% of non-nephrologists answered it (p < 0.001). While 61% of non-nephrologists prescribed sodium-glucose co-transporter 2 inhibitors to patients with CKD, regardless of diabetes complications, compared to 83% of nephrologists (p < 0.001).

CONCLUSION

The quality of CKD management by non-nephrologists partially improved in the past decade; however, the low use of guidelines and implementation of quantitative proteinuria measurements among non-nephrologists needs to be addressed in future.