Care for patients with Chronic Kidney Disease at the primary healthcare level: considerations about comprehensiveness and establishing a matrix

Chronic kidney disease is a public health problem throughout the world. Early detection and treatment can reduce morbidity, mortality and associated expenditures. The objective of this research is to examine primary healthcare from a physician's perspective, evaluating the patient's access to other levels of healthcare. Questionnaires were given to 62 family physicians working in primary healthcare units in the city of Fortaleza. Glomerular filtration rate was measured by only 8.1% of the physicians when evaluating patients with diabetes and 4.8% when evaluating hypertensive patients. The majority of physicians (51.2%) refer patients with slight/moderate Glomerular filtration rate reduction to a nephrologist. On the other hand, 25.8% do not refer patients with advanced chronic kidney disease reduction to a specialist. The gap between these levels of healthcare creates a barrier to user access, prejudicing comprehensive healthcare. The creation of new work processes is urgently required and the matrix process is a viable option to connect these healthcare levels for the care of patients with chronic kidney disease or its main risk factors (diabetes and arterial hypertension).