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AIM: To investigate primary care physicians' knowledge of and attitudes toward care for chronic kidney disease patients. BACKGROUND: In Brazil, care for chronic kidney disease, a global public health problem, is provided by the Brazilian National Health System, which is organized around primary care. The study aimed to investigate the knowledge and attitudes of primary care physicians about the management of chronic kidney disease. METHOD: This research is based on quantitative and qualitative data. The participants were 92 physicians from 81 primary care units located in eight cities of the São Paulo/Brazil health region, who answered a self-administered questionnaire. FINDINGS: Only 59% and 58% of the physicians recognized smoking and obesity, respectively, as risk factors for chronic kidney disease. Health appointments and drug therapy predominated as disease prevention strategies and less than 30% mentioned multiprofessional care and health education groups. For early diagnosis, isolated serum creatinine was the most used test and 64.6% stated they classified the disease stages. Exclusive follow-up in primary care decreased from 79% in stage 1 to 19.5% in stage 3B and the patients' monitoring in the healthcare network varied from 8.7% in stage 1 to 70.6% in stages 4 and 5ND, suggesting early referrals and lack of referral at the necessary stages. Access to information on the referred patient was, predominantly, through the patient's report and 74% of the physicians did not have matrix support regarding chronic kidney disease. CONCLUSION: The study showed that the healthcare teams need to update their knowledge and procedures to be able to provide a comprehensive and efficient approach to treating chronic kidney disease in primary care.

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Modelo do estudo: Estudo descritivo, transversal, com abordagem qualitativa. Objetivos do estudo: descrever e analisar a opinião de gestores e técnicos do setor saúde sobre os instrumentos e os recursos que integram o processo de planejamento no Sistema Único de Saúde. Metodologia: foram entrevistados 26 participantes, entre gestores e técnicos dos municípios e do estado que compõem o Departamento Regional Saúde XIII. Para análise dos dados, utilizou-se a Análise de Conteúdo em sua vertente temática. Resultados: o espaço de planejamento e cogestão regional, conhecido como Colegiado de Gestão Regional, se mostrou potente para a troca de experiências, mas apresentou fragilidades em relação a falta de coesão pelos diferentes níveis de conhecimento dos gestores e condições financeiras diversas entre os municípios. Notouse que a permanência dos gestores nos cargos foi positiva, desde que acompanhada por práticas de educação permanente. Por fim, a construção e a execução do planejamento tiveram como grandes barreiras o subfinanciamento e a judicialização na saúde, levando alguns municípios a escolha de políticas indutoras do nível federal e a terceirização da contratação de recursos humanos. Conclusão: O Colegiado de Gestores Regional apresentou grande potencial e poderia colaborar com a diminuição de retrocessos, a cada descontinuidade política, no processo de planejamento municipal e regional se fosse dado maior enfoque à coordenação federativa e ao aporte técnico do estado. (AU)

Study model: Descriptive, cross-sectional study with a qualitative approach. Objectives of the study: to describe and analyze the opinion of managers and technicians of the health sector on the instruments and resources that integrate the planning process in Unified Health System. Methodology: 26 participants were interviewed, among managers and technicians from the municipalities and the state that make up the Regional Health Department XIII. To analyze the data, we used Content Analysis in its thematic aspect. Results: The regional planning and co-management space, known as the Regional Management Collegiate, proven to be influential for the exchange of experiences, but it showed weaknesses about the lack of cohesion due to the different levels of managerial knowledge and diverse financial conditions among the municipalities. It was noticed that the permanence of the managers in the positions was positive, as long as accompanied by practices of permanent education. Finally, the construction and execution of the planning had as main barriers the underfinancing and the judicialization in health, leading some municipalities to choose policies to induce the federal level and outsourcing the hiring of human resources. Conclusion: The Collegiate of Regional Managers presented great potential and could collaborate with the reduction of setbacks, with each political discontinuity, in the process of municipal and regional planning if the greater focus given to federative coordination and state technical contribution (AU)

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