Management of patients with chronic kidney disease at Kaiser Permanente.

In the Southern California Kaiser Permanente health plan, all patients having serum creatinine measured will automatically have their GFR reported. Those with reduced GFR are identified and classified into one of the five CKD stages. The PCPs are encouraged to be involved in the care of patients in CKD stages 1-3. Education, guidelines, and algorithms are provided to the PCPs, and nephrology consultation is encouraged. Patients in CKD stage 3 with significant risk factors for developing ESRD and those in CKD stages 4 and 5 are referred to nephrologists. Patients are encouraged to participate [table: see text] in their own care by attending the educational classes provided.