Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
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The onset of clinical proteinuria in patients with diabetic nephropathy usually marks the existence of irreversible and progressive kidney damage. Prevention of chronic renal failure ought to take place in earlier stages, mostly in the outpatient setting and in close collaboration with general practitioners (GPs). This study aims to evaluate the prevalence and the clinical stage of diabetic nephropathy and to screen for progression factors in the regional community referred to the outpatient department of the nephrology unit of the Mons. DiMiccoli Hospital in Barletta; it is intended as the first phase of a collaborative project for the prevention of diabetic nephropathy. ⋯ This study shows the feasibility and the advantages of setting up a stable collaboration between hospital and primary care in order to improve the diagnosis and prevention of kidney disease. Identification of the most frequently deviant progression factors provides the primary target for the prevention of kidney damage in diabetic patients.
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Late referral to the nephrologist has been mainly examined to assess its causes and effects in patients with chronic renal failure. It has not been analyzed as a phenomenon in itself, to identify its features and allow more effective prevention plans. This study proposes a methodological approach to the study of outpatient referral to the nephrologist (ORN) by defining a number of evaluation tools. ⋯ The incidence and prevalence of renal diseases among outpatients are measures of ORN and they are useful for a qualitative analysis, such as to assess its pattern. The referral index provides a quantitative evaluation of ORN with respect to the general population of the catchment area.