Table 3 Barriers to diagnosis and management of CKD in primary care, as reported in included studies (studies listed by reference number)

 Challenges educating patients

X

X

 Challenging nature of CKD management

X

X

X

 Cost and/or burden for patients

X

X

 Fear of frightening patients with diagnosis

X

X

X

X

X

X

X

X

X

X

 Lower priority of CKD as a clinical issue

X

X

X

X

X

X

 Perception that kidney decline is to be expected in aging

X

X

X

X

 Reactive focus to healthcare

X

 Challenges using laboratory measures for CKD diagnosis or management

X

X

X

 Inadequacy of reporting process to support quality improvement

X

 Lack of patient education resources

X

X

X

 Lack of renumeration for CKD

X

X

 Limited access to nephrology

X

X

X

X

 Technological issues

X

X

X

 Time/workload

X

X

X

X

X

X

X

X

X

X

X

X

X

 Variation in practice style

X

 Dissatisfaction with guidelines

X

X

X

X

X

X

X

X

X

X

 Lack of awareness of guidelines

X

X

X

X

 Lack of awareness of resources/support services

X

X

 Perceived lack of adequate knowledge or training

X

X

X

X

X

X

X

X

 Perceived lack of clear definition of CKD

X

 Lack of patient understanding of CKD

X

X

X

X

 Perceived low patient adherence

X

X

X

X

X

 Poor communication between healthcare providers

X

X

X

X

X

X

 Lack of clear role delineation between healthcare providers

X

X

X

X

X

X

 Perception of role by other healthcare providers

X

X

X

X

X

X

 Patient perception of roles of healthcare provider/s

X

X

X