Abstract: SA-PO840
Use of Kidney Disease Progression Model Care Planning Report Associates with Lower Dialysis Catheter Rates at the Initiation of Hemodialysis
Session Information
- CKD: Socioeconomic Context and Mobile Apps
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Jiao, Yue, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Kopyt, Nelson P., Valley Kidney Specialists, A Division of Kidney Care Specialists, Allentown, Pennsylvania, United States
- Bollu, Ravindra, Valley Kidney Specialists, A Division of Kidney Care Specialists, Allentown, Pennsylvania, United States
- Casey, Kylene, Acumen Physician Solutions, Durham, North Carolina, United States
- Gopal, Sam, Acumen Physician Solutions, Durham, North Carolina, United States
- Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Wang, Yuedong, University of California - Santa Barbara, Santa Barbara, California, United States
- Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
Approximately 80% of end stage kidney disease (ESKD) patients use a central venous catheter (CVC) at the initiation of hemodialysis (HD) (USRDS 2018). A healthcare organization developed a CKD Forecaster Tool for nephrologists to use for prognostic clinical decision support and patient education in care planning for the transition from CKD to ESKD. We assessed CVC rates at the initiation of HD based on the nephrologists’ level of utilization of the CKD Forecaster Tool.
Methods
We used data from CKD patients treated by nephrology practices using Acumen Electronic Health Record system who progressed to ESKD during April 2018 to October 2019. The CKD Forecaster Tool uses an artificial intelligence modelling of historic eGFR values to predict the trajectory of eGFR values in the future. We assessed CVC rates at HD initiation in patients who progressed to ESKD stratified by the frequency of their nephrologist accessing the CKD Forecaster Tool. Only nephrologists with ≥15 CKD patients who transitioned to ESKD were used for the analysis. Frequent users accessed the tool on >1% of their CKD patients, occasional users accessed the tool on >0-1% of their CKD patients, and non-users did not use the tool.
Results
Among a population of 106,915 CKD patients treated by 309 nephrologists, we analyzed data on 6,917 patients who progressed from CKD to ESKD (this includes only nephrologists with ≥15 CKD patients who transitioned to ESKD). A total of 30 nephrologists were frequent users of the CKD Forecaster Tool, 39 were occasional users, and 240 were non-users. Patients treated by nephrologists who used the CKD Forecaster Tool exhibited 1% to 2% lower CVC rates at HD initiation (Figure 1).
Conclusion
Nephrologists who used the CKD Forecaster Tool had slightly less patients transitioning to HD with a CVC. Further assessments are needed to determine if greater adoption and consistent use of the CKD Forecaster Tool over time is associated with larger improvements.
Funding
- Commercial Support – Fresenius Medical Care North America