Prevention and early detection of chronic kidney disease in family medicine

Chronic kidney disease (CKD) is a progressive impairment of kidney function or structure, associated with an increased risk of cardiovascular disease, kidney failure, and premature death. Due to its often asymptomatic onset, the disease frequently remains undetected for a long time. High prevalence, delayed diagnosis, low awareness among the general population, and high treatment costs in advanced stages make CKD a significant public health problem. Family physicians play a key role in the prevention and early detection of the disease, slowing its progression, timely recognition of risk factors, and appropriate referral for diagnostic evaluation in order to reduce the risk of adverse outcomes. The most important risk factors for disease development include arterial hypertension, diabetes mellitus, obesity, unhealthy lifestyle habits, and exposure to nephrotoxic agents and medications. Diagnosis is established by estimating the glomerular filtration rate based on serum creatinine (eGFRcr) and determining the albumin-to-creatinine ratio in urine (uACR) which is easy to determine in primary health care. Prevention of disease onset and progression is based on lifestyle modification, adequate management of comorbidities, and use of nephroprotective medications. Raising awareness of CKD, conducting targeted screening in at-risk populations, patient education and a comprehensive, individualized approach by family physicians to individuals at increased risk or already affected by CKD enable early intervention and reduce the likelihood of adverse health outcomes.