FMQAI - The Medicare Quality Improvement Organization                                                                      August 2009

Featured LINKS

www.fmqai.com/ESRD/ The End Stage Renal Disease Network 7

www.aakp.org  The American Association of Kidney Patients

www.kidneyfla.org  The National Kidney Foundation

www.nkdep.nih.gov  The National Kidney Disease Education Program 

FREE Cultural Competency Resources

Minority populations are more likely to develop CKD than non-minority populations. Studies show that African Americans, Native Americans, Hispanics and American Asians are, respectively, 4.5, 3.6, 2 and 1.6 times more likely to develop CKD than are Caucasians.  Click here for free resources.

CONTACT US

For resources or technical assistance on the Chronic Kidney Disease Project, call 1.800.564.7490 and ask for a member of the CKD Team or email CKDTeam@fmqai.com.

CKD Progresses More Slowly in Women

Data show that men are 30% more likely than women to start renal replacement therapy.

Renal disease progresses more slowly in women than men even though women have a lower estimated glomerular filtration rate (eGFR) at the time of referral to a nephrologist, according to Canadian researchers.

For the complete story, click here.

 

The Top 10 Things Nephrologists Wish Every Primary Care Physician Knew

Early detection and treatment are important in slowing the progression and preventing complications in chronic kidney disease (CKD).  An article in the Mayo Clinic Proceedings, discussed ways to avoid common pitfalls in recognizing and treating CKD.  The evidence-based pearls given in the article are to help primary care physicians who encounter patients with renal disease in their daily practice:

  1. A "normal" serum creatinine level may not be normal.
  2. Know the medications that spuriously elevate the serum creatinine level.
  3. Patients with decreased GFR or proteinuria should be evaluated to determine the cause; positive urine dipstick tests results for protein should be followed up with a spot urine protein to urine creatinine ratio.
  4. In patients with early-stage CKD, periodic evaluation and intervention are appropriate to slow the progression of renal disease and avoid its complications.
  5. Do not automatically discontinue an ACEI or ARB solely because of a small increase in the serum creatinine or potassium level.
  6. Anemia in patients with CKD should be treated with erythrocyte-stimulating agents such as recombinant human erythropoietin but should not be overtreated.
  7. Phosphate-containing bowel preparations should be used with caution.
  8. Patients with severe CKD should avoid magnesium or aluminum-containing oral preparations.  Concomitant use of citrate-containing preparations and aluminum-containing oral preparations is potentially hazardous because it can lead to acute aluminum toxicity.
  9. Although most patients with hypertension should not be screened for secondary hypertension, certain clinical clues may suggest the presence of an underlying cause that when addressed, may resolve or improve the patient's hypertension.
  10. In patients with recurrent stone disease, an indepth metabolic evaluation is needed to identify and treat modifiable risk factors, thereby preventing further episodes and/or promoting stone dissolution.

Mayo Clin Proc 2009; 84 (2):180-186

For a complete discussion of CKD and other renal conditions discussed in this article, click here to go the the cited reference.

 

National Kidney Diseases Education Program FREE Provider Education Videos

To support and encourage conversations between health professionals and patients, NKDEP has developed a series of short videos that show possible approaches health professionals can use to explain different aspects of CKD.

The videos are grouped by NKDEP’s four key concepts for kidney disease education. Learn more about the four concepts and get talking points for each.

There is no single best way to talk to your patients about CKD. Watch these videos to give you ideas for how you can tailor the talking points in your own practice.

 

The Medicare Quality Improvement Organization

FMQAI serves as the Medicare Quality Improvement Organization and End Stage Renal Disease Network (ESRD Network 7) for Florida. With a strong reputation as a leader in facilitating change and collaboration, FMQAI implements projects and conducts case review activities to improve care across all settings, including dialysis and transplant facilities.

This material was prepared by FMQAI, the Medicare Quality Improvement Organization (QIO) for Florida, under contract with the Centers for Medicare & Medicaid Services, (CMS), an agency of the U.S. Department of Health and Human Services.  The contents presented do not necessarily reflect CMS Policy.  FL2009F73T1ABC1211320  www.fmqai.com