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Kidney Week

Abstract: SA-PO500

Survey of Contemporary Management of ADPKD Highlights Need for Improved Knowledge Translation

Session Information

  • ADPKD: Clinical Studies
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

  • 1001 Genetic Diseases of the Kidney: Cystic

Authors

  • Yi, Tae won, University of British Columbia, Vancouver, British Columbia, Canada
  • Canney, Mark, University of British Columbia, Vancouver, British Columbia, Canada
  • Levin, Adeera, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
  • Bevilacqua, Micheli U., University of British Columbia, Vancouver, British Columbia, Canada
Background

Recent years have witnessed a paradigm shift in the management of ADPKD, including novel biomarkers of disease progression such as total kidney volume (TKV), refined blood pressure (BP) targets, and repurposed drugs such as Tolvaptan. We sought to identify clinician’s familiarity with and usage of these new management tools in contemporary-real world practice.

Methods

An online survey of 20 questions was disseminated to 71 nephrologists across British Columbia. The survey consisted of multiple choice questions regarding: clinician demographics, sources of information regarding ADPKD care, self-identified needs for optimal management of ADPKD, types of renal prognostication tools used, imaging tests and frequency of follow up imaging, blood pressure targets, and understanding of Tolvaptan utility.

Results

A total of 22 nephrologists (28%) completed the questionnaire. 89% of respondents are assessing risk of renal progression before GFR decline in their ADPKD patients, with a variety of tools being used. 90% of respondents obtain additional imaging after diagnosis in some or all of their ADPKD patients, but only 40% report use of imaging to assess risk of renal progression. 1 in 5 respondents are confident in their ability to interpret metrics of kidney size in ADPKD. 60% of nephrologists have been approached by patients about Tolvaptan, but 55% of respondents were not confident or only somewhat confident in their ability to identify which patients would benefit from treatment with Tolvaptan. Only 30% of respondents use the HALT-PKD BP target of <110/75 with the remainder using higher BP targets. The necessity for clear treatment guidelines and algorithms was identified by 25% of clinicians as the greatest unmet need.

Conclusion

The results of this survey indicate that there is variability in practice patterns, usage and familiarity with evidence-based ADPKD management tools among clinical nephrologists. Although only a minority of clinicians are confident in their ability to use these new tools and treatments appropriately, the vast majority show interest in further education. This emphasizes a need for ongoing efforts to translate these developments in ADPKD care into routine clinical practice.