SP335CHRONIC KIDNEY DISEASE (CKD) INTEGRATION ACROSS THE CARE CONTINUUM BETWEEN PRIMARY CARE-TERTIARY HOSPITAL

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INTRODUCTION AND AIMS: The coordination between nephrology and primary care is well documented in the management of chronic kidney disease (CKD), but the real impact is less clear. We estimated the prevalence of Chronic Kidney Disease (CKD) and evaluated an outpatient nephrology program (ONP) implanted progressively in “Barcelona Esquerra”, an area of Barcelona with 524,395 inhabitants, accounting for more than 30% of the city's population. METHODS: We have applied the EPIRCE study results in general population between 2004 and 2014 and the EROCAP study in assisted population for estimation of the CKD. The number and age of the new referrals to nephrology between 2004 and 2014 were identified and a referral index (RI) was established between the number of new outpatient visit referred from Primary Care to Nephrology and the estimated prevalence of CKD in the population served, available since 2010. RESULTS: The adult population decreased from 450,027 to 438,782 between 2006 and 2014, while the number of inhabitants older than 65 years old increased from 107,025 to 113,461 and so did the estimated CKD. Renal insufficiency was the reason for more than 70% of the referrals made to nephrology. The average age was 74 years old in 2004-2009 and 70 in 2010-2014. The RI showed two trends, in the analyzed period, depending on the ONP includes or not the face-to-face consultancy. The impact of the ONP in the relationship between both healthcare levels can be seen in the attached table. SP335 Figure

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