CKD intercept- A Primary Care Initiative from NKF

Our nation is aging, not always gracefully, and there is a large burden of CKD to manage. 13% of US adults have CKD stages 1-5 with less than 0.5% having stage 4-5 CKD (USRDS 2015 ADR, partially based on NHANES data). Most of the work in managing CKD will not take place in a nephrology office. Exploring this data further (which is well worth your time) unfortunately also reveals that: < 10% of patients with stage 3 CKD know they have CKD; < 50% of patients with diabetes (without known CKD) receive yearly albuminuria screenings; and around 50% of patients with CKD are not at their target blood pressure or A1c. Furthermore, one US multicenter, observational study (ADD-CKD, Szczech et al. PLOS One, 2014, 9: e110535) noted that of over 9,000 patients with diabetes, over 50% had CKD yet barely 10% of patients were identified as having CKD in their medical records. Without actively recognizing and managing CKD, patients may miss out on core treatment (RAASi, hypertension control, etc.).

So, if there is room to improve the care of patients with early CKD within the primary care setting; how can we, as specialists, help our colleagues. To help with these concerns the NKF is developing a primary care initiative called CKDintercept. This is designed to provide “knowledge and tools to alter chronic kidney disease (CKD) outcomes, improve patient’s quality of life, and have an impact on CKD healthcare spending nationwide.” This developing program will involve education (of providers and patients) as well as systems based approaches to improving CKD care.

The first educational program, on the detection and management of CKD in the primary care setting, is now being rolled out. The program, called CKDinform Early Detection and Prevention, is designed to “improve CKD diagnosis and create a culture of kidney preservation and protection in busy primary care settings.”

The program consists of three PowerPoint based educational modules, designed to be presented by nephrologists or primary care leaders to members of the primary care team (including physicians, mid-level providers, pharmacists, diabetes educators, etc.).

The content within the three modules covers item such as:

• The epidemiology and financial impact of CKD.
• Risk factors for CKD, indications for screening, and diagnosis of CKD.
• Guidelines for nephrology referral.
• Medication safety in CKD.
• Treatments to reduce CKD progression.
• A basic review of renal replacement therapy including transplantation. 

The presentations can be used together within a larger symposium or individually within faculty meetings or Grand Rounds. The NKF has also created additional educational resources (such as a CKD risk assessment tool or CKD management algorithm) which can be given to participants. Presenters are allowed to adjust the presentation as they see fit however there are “core-slides” the NKF has identified for each of the three presentations. Importantly, CME/CE credit can be given to participants if these “core-slides” are used and there is not another CME system in place.

This program offers nephrologists resources to help educate their primary care colleagues and potentially improve the care of the patients they see, and more importantly those they may never see. Further information on how to access and utilize the materials, as well as contact info for the NKF, is provided at the links above.

Post by Robert Rope- Nephrology Fellow- Stanford
Reviewed by NKF

RFN teams up with NKF

The editors and contributors of Renal Fellow Network (RFN) are proud to announce the partnership with the National Kidney Foundation (NKF).  You will notice a few changes which we hope will help enhance the site. First, we have a new logo.  This logo reflects the global vision we hope to create - a place where Nephrology fellows from around the world can meet and discuss issues relevant to Nephrology patient care, research and education.  Secondly, we will add informational content relevant to conferences, grants and fellowships.  

We are delighted to team up with NKF, and believe this is an exciting opportunity for both parties.  This collaboration serves to help sustain the site for future Nephrology fellows, by creating an editorial board composed of Nephrology fellows whose mission will be to keep the integrity and mission of the site intact.  The NKF does not provide monetary support to RFN.  From our perspective, we hope the collaboration will further raise the profile of the site, allowing us to reach an even wider audience. Our ultimate goal is to provide an integrated hub for all Nephrology practitioners, providing useful and up to date clinical and research information, permitting discourse on topics of clinical or career interest, and serving a go-to source for information on grants, fellowships and other information relevant to Nephrologists, whatever the stage of their careers.  If you are interested in becoming a contributor please contact either the editor or deputy editor.  Also, if you have suggestions for ways we can improve or develop RFN, please get in contact!