Objective: To evaluate the effectiveness of the Operations Manual protocol of the Specialties Medical Units for Chronic Diseases (UNEMEs EC) by analyzing the evolution of renal function and risk factors for progression, during one year, in 376 referred diabetic patients by a health centers network. 

Methods: The staff was trained by the National Center for Disease Prevention and Control with the "Master Class: Early Detection of Kidney Disease to Prevent End-Stage Kidney Disease." We analyzed 70 patients diagnosed with Chronic Kidney Disease (CKD) (initial glomerular filtration rate ≤ 59 ml/min/1.73 m2) and 306 patients without the disease (initial glomerular filtration rate ≥ 60 ml/min/1.73 m2). The initial and final values of systolic blood pressure, diastolic blood pressure, total cholesterol, highdensity lipoproteins, low-density lipoproteins, HbA1c, weight, body mass index, plasma creatinine, and glomerular filtration rate were compared. 

Results: Patients with chronic kidney disease improved their renal function by 1 to 9 ml/min/1.73 m2 with a 95% confidence level. Patients without CKD did not present changes. The significant risk factor was body mass index. Recognition of the complex interrelationship between variables contributing to kidney function decline confirms the need for training of health personnel. 

Conclusion: The application of the norms by a multidisciplinary group improved renal function in patients with CKD and prevented its deterioration in patients without CKD. Both nephroprotection and improved kidney function were achieved, which supports a recommendation to extend the model used in this study to other primary health care units, as a cost-benefit ratio was demonstrated.

A physician originally from Mazatlan, Sinaloa, he completed his undergraduate studies at the UNAM School of Medicine and specialized studies in Internal Medicine and Nephrology at the "Salvador Zubiran" National Institute of Nutrition. (INNSZ) He completed his postgraduate studies as a fellow at the University of Texas Medical School in San Antonio, Texas. He was a full-time professor at Autonomous University of Sinaloa. He was a pioneer of dialysis and kidney transplantation in Sinaloa. He was a pioneer of basic health research in the state through funding from CONACYT and the pharmaceutical industry. He was a nephrologist at INNSZ. He was Medical Director of RENCorporation México. A subsidiary of RENCorporation USA, for the creation of a hemodialysis network (1993-1995).