Kidney Disease Research Updates
Winter 2008

NIDDK News

NKDEP Urges Primary Care for People with CKD

Primary care providers are key to addressing the problem of undertreated and underdetected cases of chronic kidney disease (CKD), according to National Kidney Disease Education Program (NKDEP) Director Andrew S. Narva, M.D., F.A.C.P.

Clinicians in primary care settings could do more to manage CKD patients, Narva said at an October NKDEP coordinating panel meeting, but do not do so because they feel unprepared to intervene. The NKDEP’s goal, according to Narva, is to educate health care professionals to consider CKD a part of primary care and offer simple tools to help them provide that care.

“Chronic kidney disease is usually ignored until creatinine levels reach a level that alarms primary care providers, who then refer patients to specialists,” said Narva. “We need to promote earlier intervention.” According to Narva, earlier intervention can slow the rate of decline of kidney function, delaying and possibly preventing the need for dialysis.

An estimated 13 percent of people in the United States—about 26 million—have CKD, according to recent statistics from the U.S. Renal Data System, which is funded by the National Institutes of Health and the Centers for Medicare and Medicaid Services.

Chronic Care Model

Narva said the NKDEP can be instrumental in enhancing CKD interventions in the primary care setting by using the chronic care model. The chronic care model emphasizes a health care team approach, clinical case management for complex patients, evidence-based guidelines for daily clinical practice, and self management of patient care.

“The chronic care model offers a systematic way to identify needs and set priorities,” said Narva. “The NKDEP is best suited to develop the messages, tools, and materials that can be used to educate providers and patients about CKD—and to facilitate more productive interactions between them.”

Other NKDEP Initiatives

In addition to promoting CKD within the primary care setting, other NKDEP priorities include focusing outreach on those most at risk, redesigning the program website, and facilitating collaboration among federal agencies involved in CKD activities.

To promote a coordinated federal response to CKD, the NKDEP has expanded the annual Kidney Interagency Coordinating Committee (KICC) meeting to a year-round initiative of collaboration and information sharing. KICC participants include federal agencies with significant involvement in kidney disease. The NKDEP is developing an online directory of KICC members.

The NKDEP also has been pilot-testing a new tool for assisting health care professionals in explaining the estimated glomerular filtration rate (eGFR), a measure of kidney function, to patients. The tool, a tear-off pad, includes multiple copies of a fact sheet with talking points and simple language and visuals to explain the eGFR. The NKDEP will make the eGFR pad available nationally following testing at nine community health centers.

For a summary report of the meeting and Narva’s presentation, go to www.nkdep.nih.gov/about/panel.htm#meeting. For patient education materials, including publications specifically for African Americans about kidney disease and other information from the NKDEP, go to www.nkdep.nih.gov.

NIH Publication No. 08–4531
March 2008

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