Chronic kidney disease: New paradigms in diagnosis and management.

This article provides a step-by-step approach to evaluating kidney function and appropriately treating chronic kidney disease (CKD) in a primary care setting. Early detection and management of CKD will decrease the rate of progression to end-stage renal disease.

The right patient, the right treatment, the right access and the right time.

As the incidence of CKD increases, so will the ESRD population. Pre-ESRD care, including early referral to nephrology and patient education, enables patients and providers working together to determine which therapy modality is best suited for their individualized needs: conservative therapy, kidney transplant, hemodialysis, or peritoneal dialysis. Differentiating the therapy modality should be based on many factors and not solely based on outcome data.