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Abstract: TH-PO018

Early Recognition of CKD in Primary Care Setting

Session Information

  • Educational Research
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 900 Educational Research


  • Johnston, Alexandra M., Allegheny Health Network, Pittsburgh, Pennsylvania, United States
  • Sealey, Mary Lynn, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
  • Mathos, Lauren, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
  • Gadani, Mrudula, Allegheny Health Network, Pittsburgh, Pennsylvania, United States

Chronic kidney disease (CKD) affects 37 million people in the US but 10% are aware they have CKD. Recognizing CKD early in the disease has shown to improve outcomes while failure to do so can lead to increased morbidity and mortality. In the 2020-2021 academic year, there were 28,569 Internal Medicine Residents in the US and this group is of critical importance in identifying patients with CKD.


We aimed to identify and increase screening of CKD in patients in our residency clinic by implementing a small group case-based didactic on recognizing and screening for CKD along with management once diagnosed. We also conducted a pre/post-test to determine the effectiveness of the didactic. Residents were encouraged to utilize a smartphrase created in EPIC to identify patients with risk factors that should be routinely screened for CKD. Baseline data of patients with a diagnosis of CKD was collected and again at 6 months.


Ninety five residents participated in didactics with an average pre-test of 2.9/8(36.2%) which improved to 5.7/8(70.7%) post-test. At baseline, a total of 235 patients had a diagnosis of CKD out of 3900 patients (6.0%). 6 months after didactic and implementation of SmartPhrase, a total of 286 out of 4050 patients had a diagnosis of CKD (7.1%). There was an overall increase in patients screened and diagnosed with CKD. Most notable change was in patients over age 65 years and black patients with an increase from 16.7% (149/892) to 19.7% (187/949) and 9.7% (139/1433) to 11.4% (163/1435) respectively.


Kirkpatrick evaluation model was utilized to assess our CKD focused small group case-based didactic and QI intervention. Learning was evaluated with pre/post-test showing an increase in scores by 34%. In addition, behavioral change was noted by utilization of SmartPhrase and subsequently resulted in an increase in identification of patients with CKD with largest increase in patients over age 65 years and black patients. Use of a similar hybrid intervention in Internal Medicine Training programs may be beneficial to increase CKD recognition across the country. Future measurement of treatment parameters including blood pressure control and medication use are planned.