NEPHROLOGIST CONNECT

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Nephrologist Connect by the Numbers

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Patient Care

The Dual Approach: Why uACR and eGFR Testing Should Go Hand in Hand in CKD Management?

Now that we have more options in treating CKD and they are based on proteinuria, it is important to follow this as a marker for risk of progression. eGFR is also important for patients and providers to see that small changes in creatinine level often mean bigger changes in renal dysfunction. I think nephrologists are pretty good and monitoring these but often gets missed by other providers and perhaps quality incentives for MSSP and ACO's can include this.

Slide 1

Prescribing Decisions

2024 update to KDIGO’s chronic kidney disease guidelines

Multidisciplinary approach is always needed in CKD care. We have this model in our clinic where the patients gets seen by the nephrologist, CKD nurse educator, dietitian and pharmacist to ensure we do everything to slow down the progression of CKD. The main updated guidelines include the use of SGLT2i to slow down the progression of CKD. Also the use of non steroidal MRA to help with CKD care.

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Patient Care

Enhancing CKD management: The critical role of both uACR and eGFR in comprehensive patient assessment

Albuminuria is not only an early indicator of kidney disease, but it is also a promoter of more rapid kidney disease progression and an independent risk factor for coronary artery disease! The higher the level of albuminuria, the worse the risk. So it is imperative to test early and often. In my patients with diabetes, I assess microalbuminuria every 3 months, and those without diabetes, at least annually (more often if they have a known proteinuria kidney disease. Fortunately, we now have a wide range of medical therapies that can have a substantial impact on kidney health, allowing people to live many more years than ever before without the need for kidney replacement treatments.

Slide 4

Patient Care

Enhancing CKD management: The critical role of both uACR and eGFR in comprehensive patient assessment

I assess albuminuria in all of my patients with CKD risk factors. Albuminuria is a significant risk factor for progression of chronic kidney disease, regardless of CKD stage. If it is significant, then additional therapeutic regimens can be considered, including RAS inhibitors, SGLT2 inhibitors, and even thiazide diuretics, which have also been shown to improve Albuminuria.

Slide 5

Patient Care

Enhancing CKD management: The critical role of both uACR and eGFR in comprehensive patient assessment

Slide 2

Patient Care

Treatment counseling for patients with ADPKD

It is important that patients understand that early therapy can have a greater impact to slow progression. This is hard as many patients don't have symptoms and may not be eager to take medications, especially if they lead to side effects. I like to show patients kidney function survival and how therapies may slow the development of ESKD. I think that this is very effective.

NEPHROLOGIST CONNECT

A SKIPTA COMMUNITY

Nephrologist Connect by the Numbers

What are HCPs talking about?

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