Résumé
Context: Chronic Kidney Disease (CKD) is common, with its incidence and prevalence continually increasing. Its management has become a public health concern to delay progression to end-stage and alleviate the burden it places on patients and the healthcare system. Our objective was to describe and synthesize the care pathway and management of CKD at early to moderate stages to optimize patient care. We used a systematic literature review methodology through a project named ChroKiDEL for "Chronic Kidney Disease Early stage Literature review."Materials and methods: we searched databases including PubMed, Embase, Cochrane, PdQ Evidence, and KT+ from the years 2000 to 2022 to identify studies concerning the care pathway and/or management of ambulatory patients over 18 years old with early to moderate CKD. The studies involved primary, secondary, and/or tertiary care in high-income countries. Two evaluators independently performed article selection meeting our inclusion criteria, data extraction, and evaluation of study quality. Identified studies were classified into subgroups by country.Results: the results of this review focused only on data from Canada and Oceania. 16 studies were included. Gaps were identified in early-stage CKD screening and recognition, care coordination, management of medication therapies, and urinary screening of risk factors. Quality improvement initiatives were proposed, such as online clinical pathways or selfmanagement interventions to support general practitioners in their care coordination role and involve patients in their own care. Conclusion: optimal CKD care relies on an interaction between self-management and primary care, supported by secondary and tertiary care. While quality improvement initiatives are necessary to optimize patient care and follow guidelines, a patient-centered, individualized, and preventive approach is crucial.