Abstract

Background: Chronic kidney disease (CKD) is a common health issue, and proper screening and management are important for slowing disease progression. As primary care physicians, family medicine (FM) trainees are well-positioned to diagnose and manage early CKD. The objective of this study is to assess the current level of awareness, management practices, and challenges faced by FM trainees in managing CKD.
Methods: An online survey was conducted among 250 FM trainees across multiple regions, focusing on their understanding of CKD staging, management guidelines, and barriers to effective care. Statistical analysis was performed using Statistical Package for the Social Sciences version 27, presenting descriptive statistics and computing proportions. The Fisher’s exact test was used for comparisons.
Results: The results revealed key knowledge deficits, particularly in evaluating CKD stages based on glomerular filtration rate (GFR) cutoffs. Most respondents reported screening for metabolic acidosis at a creatinine clearance of less than 30 ml/min (66.5%), anemia at less than 60 ml/min (73.5%), and malnutrition at less than 30 ml/min (68.4%). Hypertension and diabetes were recognized as high-risk conditions in CKD by 95.8%
of respondents. In managing hypertension in CKD patients, angiotensin-converting enzyme inhibitors were commonly used (78.6%). For anemia treatment, erythropoietin or darbepoetin was used in 78.6% of patients, and oral iron was used in 65.1%. Most trainees (56.7%) referred patients with diabetic nephropathy to nephrologists at a GFR of less than 60 ml/min, while 61.4% recommended timely vascular access for hemodialysis
at a GFR of less than 15 ml/min.
Conclusion: The study concludes that there is a need for enhanced education and training programs for FM trainees to address these knowledge gaps and improve CKD management. Additionally, addressing factors such as time constraints and limited access to nephrology consultations could significantly improve the quality of CKD care in primary care settings.

Key words: Chronic kidney disease, family medicine trainees, CKD management, knowledge gaps, barriers, ACE inhibitors.