Minnesota Physician October 2014

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Psychiatric consultations for children Practical, convenient, and free resources for primary care By Todd Archbold, LSW, MBA, and Linda Vukelich


Chronic kidney disease A call to action for defeating a silent epidemic By Surabhi Thakar, MD; Marc Weber, MD; and Gail Torres, MS, RD, RN


hronic kidney disease (CKD) is a devastating diagnosis that is increasing in prevalence, and is associated with a high rate of morbidity and mortality. Approximately 26 million Americans are living with CKD, and this is primarily due to diabetes and hypertension, the two most common causes of the disease. CKD is the ninth-leading cause of death in the United States, and according to

the United States Renal Data System (USRDS) 2013 Annual Data Report, there is nearly a fivefold reduction in life expectancy for dialysis patients compared to the general population. Of the four most serious cancers, only lung cancer has a worse mortality rate than CKD. In the 2004 landmark study by Go et al., it also was demonChronic kidney disease to page 20

or decades, the shortage of child and adolescent psychiatrists (CAPs) and other specialized mental health practitioners has resulted in the challenge of meeting the overwhelming mental health needs in communities all over the country. These needs include managing chronic illnesses like depression, anxiety, and other mood disorders; to triaging and treating acute disorders, like suicidality, that rise to the level of a psychiatric emergency. The CAP shortage has shifted the burden of providing mental health care to primary care clinicians, many of whom feel ill-equipped to manage complex psychiatric illnesses during brief office appointments with little support. Psychiatric consultations for children to page 10