Clin Exp Nephrol. 2026 Jan 31. doi: 10.1007/s10157-026-02821-0. Online ahead of print.
ABSTRACT
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.
PMID:41619139 | DOI:10.1007/s10157-026-02821-0