The Medical clinics of North America
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Diabetes is a major public health challenge and diabetic kidney disease (DKD), a broader diagnostic term than diabetic nephropathy, is the leading cause of chronic kidney disease and end-stage kidney disease in the United States and worldwide. A better understanding of the underlying pathophysiological mechanisms of DKD, and recent clinical trials testing new therapeutic interventions, have shown promising results to curb this epidemic. Given the global health burden of DKD, it is extremely important to prioritize prevention, early recognition, referral, and aggressive management of DKD in the primary care setting.
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Med. Clin. North Am. · Jul 2023
ReviewSecondary Hypertension Overview and Workup for the Primary Care Physician.
Secondary hypertension occurs in 5% to 10% of all patients with hypertension. Given the majority of patients with hypertension will not have a secondary cause, only select patients with specific characteristics should be screened. ⋯ When considering which disorders to test for, it is important to incorporate the clinical history, family history, and prevalence of each disease. Treatment is specific to the underlying cause and includes medications, procedures, surgery, and device therapies.
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Patients with cancer may develop kidney disease with a variety of different clinical manifestations including acute kidney injury, chronic kidney disease, hypertension, proteinuria and electrolyte disturbances. Onco-nephrology is the subspecialty of nephrology that diagnoses and manages kidney disease in patients with cancer. In this article, we review major topics in Onco-Nephrology that may be encountered by the general internist.
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Med. Clin. North Am. · Jul 2023
ReviewOverview of Renal Transplantation for Primary Care Physicians: Workup, Complications, and Management.
Kidney transplantation remains the treatment of choice for eligible patients with end-stage kidney disease. The last few decades have seen an expansion in the transplant recipient pool with over 250,000 patients living with a kidney transplant today. ⋯ As a result, it is becoming increasingly important for primary care physicians to have a nuanced understanding of medications, complications, and chronic medical problems unique to transplant recipients. This article reviews the role of the primary care office in helping streamline the pretransplant evaluation process and long-term posttransplant care.
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Urinalysis is a widely used diagnostic tool to assist clinicians in determining the etiology of various acute or chronic pathologies. Primary care, general internal medicine, and family medicine clinicians should be adept at identifying indications for urinalyses, in addition to appropriately interpreting their results. In this article, we provide an overview of urinalysis for non-nephrologists.