Coordination of primary care for patients with chronic kidney disease on dialysis: revisiting roles

Abstract

The number of patients on dialysis has increased significantly in recent years. These patients are, in general, carriers of multiple and complex chronic conditions, and the coordination of their care becomes a challenge. This article aims to summarize the results of the literature regarding the coordination of care for dialysis patients. This is an integrative review based on data published and available in the databases: LILACS, SciELO and PubMed. 16 articles published between 1992 and 2020 were identified. Based on the thematic analysis, five areas were highlighted: linkage of patients with primary health care (PHC) and with the family and community physician (FCF); professionals' perception of their roles and skills; patients' perception of the professionals' roles and skills; primary care delivered by nephrologists and FCF and; impact of PHC on mortality, hospitalization and quality of life. The results suggest that the nephrologist has assumed the role of care coordinator and main provider of primary care for dialysis patients. However, this does not mean that the care offered is adequate for the patient's needs, and the FCF should be increasingly involved with this care.