An integrated approach to care for patients with chronic kidney disease.

Although the Kidney Disease Outcomes and Quality Initiative (K/DOQI) guidelines serve to integrate the multiple stages of chronic kidney disease (CKD), in practice, the treatment of kidney disease over its progressive course may be somewhat fragmented. Because the provision of integrated care across the stages of kidney disease, is likely to be advantageous for both patients and care providers, a conceptual framework which graphically depicts the complex and chronic nature of kidney disease may prove useful. The Life Options Rehabilitation Advisory Council (LORAC) proposes a cycle diagram to reflect the chronicity and complexity of kidney disease and to emphasize a holistic perception of kidney disease from its inception to the worst-case scenario outcome of kidney failure [corrected]. The kidney disease cycle conceptualization can serve as a patient teaching aid and as a reminder of the communication, collaboration, and cooperation that are required among primary care physicians and practitioners in each of the specialty areas that address the spectrum of kidney disease.