Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;35(8):2057-2065.
doi: 10.1007/s40620-022-01353-6. Epub 2022 Jun 14.

"The Disease Awareness Innovation Network" for chronic kidney disease identification in general practice

Francesco Pesce  1 , Domenico Pasculli  2 , Giuseppe Pasculli  3   4 , Luca De Nicola  5 , Mario Cozzolino  6 , Antonio Granata  7 , Loreto Gesualdo  8
Affiliations

"The Disease Awareness Innovation Network" for chronic kidney disease identification in general practice

Francesco Pesce et al. J Nephrol. 2022 Nov.

Abstract

Background: The "awareness gap" and the under-recognition of chronic kidney disease (CKD) by general practitioners (GPs) is well documented. We set a framework to evaluate the impact in primary care of targeted training and networking with nephrologists with regard to CKD awareness in terms of potential increase of the proportion of patients classified according to KDIGO in the general population and in patients with diabetes, hypertension and heart failure.

Methods: Data were extracted from the Millewin Digital Platform in use by the GPs (N = 17) at baseline (T0, N = 17,854) and after 6 months (T6, N = 18,662) of networking (education, instant messaging and selected joint visits) with nephrologists (N = 2). The following variables were extracted: age, sex, eGFR (estimated glomerular filtration rate), ACR (urinary albumin-to-creatinine ratio), presence of type 2 diabetes, hypertension and heart failure. The proportion of patients detected having an eGFR below 60 mL/min/1.73m2 was also reported as deemed clinically relevant.

Results: We observed an increase in the use of ACR and eGFR tests in the entire cohort (+ 121% and + 73%, respectively) and in patients with comorbidities. The proportion of patients with eGFR < 60 mL/min/1.73m2 significantly increased from 2.2% to 3.8% in the entire cohort, from 6.3% to 12.7% in patients with diabetes, and from 5.6% to 9.9% in those with hypertension and finally from 10.8% to 23.7% in patients with heart failure.

Conclusions: Training and network support to GPs by nephrologists can improve CKD awareness and increase its identification in the general population and, even more, in categories at risk.

Keywords: Awareness; Chronic kidney disease; Early diagnosis; Primary care.

PubMed Disclaimer

Conflict of interest statement

FP received fees from AstraZeneca for lectures. DP, GP have no disclosure. LDN received fees from Astellas, AstraZeneca, Bayer, Novo Nordisk and Vifor for lectures and scientific consultations MC received research funding from Abbvie, Baxter, Keryx, and Shire; reports receiving honoraria from Abbvie, Amgen, Astrazeneca, Baxter, Shire, and Vifor-Pharma; reports serving as a scientific advisor or member of and reports speakers bureau for Abbvie, Amgen, Keryx, Shire, and Vifor Pharma GA received fees from AstraZeneca for lectures LG received research fundings from Abionyx, Sanofi, and received fees from Fresenius, Estor, Werfen, Astellas, AstraZeneca, Travere, Sandoz, Baxter, Mundipharma, Pharmadoc, Retrophin, GSK, Novartis, Chinook.

Figures

Fig. 1
Fig. 1
Study design and Statistical analyses scheme
See this image and copyright information in PMC

References

    1. Glassock RJ, Warnock DG, Delanaye P. The global burden of chronic kidney disease: estimates, variability and pitfalls. Nat Rev Nephrol. 2017;13(2):104–114. doi: 10.1038/nrneph.2016.163. - DOI - PubMed
    1. Levin A, et al. Kidney Disease improving Global Outcomes (KDIGO) CKD Working Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1–150.
    1. Shlipak MG, Tummalapalli SL, Boulware LE, Grams ME, Ix JH, Jha V, Kengne AP, Madero M, Mihaylova B, Tangri N, Cheung M, Jadoul M, Winkelmayer WC, Zoungas S, Conference Participants The case for early identification and intervention of chronic kidney disease: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference. Kidney Int. 2021;99(1):34–47. doi: 10.1016/j.kint.2020.10.012. - DOI - PubMed
    1. Zillich AJ, Saseen JJ, Dehart RM, Dumo P, Grabe DW, Gilmartin C, Hachey DM, Hudson JQ, Pruchnicki MC, Joy MS, Nephrology Practice and research networks of the American college of Clinical Pharmacy Caring for patients with chronic kidney disease: a joint opinion of the ambulatory care and the nephrology practice and research networks of the American College of Clinical Pharmacy. Pharmacotherapy. 2005;25(1):123–143. doi: 10.1592/phco.25.1.123.55628. - DOI - PubMed
    1. Neuen BL, Chadban SJ, Demaio AR, Johnson DW, Perkovic V. Chronic kidney disease and the global NCDs agenda. BMJ Glob Health. 2017;2(2):e000380. doi: 10.1136/bmjgh-2017-000380. - DOI - PMC - PubMed

Publication types