Abstract: FR-PO963
The Role of Patients' Education in Improving Quality Outcomes in CKD
Session Information
- CKD Interventions: Trials and Quality Improvement
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Abdulrahman, Rula A., Stony Brook University, Stony Brook, New York, United States
- Mallipattu, Sandeep K., Stony Brook University, Stony Brook, New York, United States
Background
CKD prevalence in US is ~ 14%. The measures to delay CKD progression are well known to providers but not to most patients with CKD, specifically minorities and patients in the lower socioeconomic class. Providing intense CKD education can improve quality outcome in this population and delays dialysis requirement. Home dialysis (HoD) therapies have been associated with improved quality of life and reduced costs, in US HoD percentage is ~13%. Currently most patients start dialysis with central venous catheter (CVC) ~ 83%in US, our goal is to increase HoD, efficiency of arteriovenous fistula (AVF) or arteriovenous graft (AVG) placement, and to increase referrals and listing for kidney transplantations (KT), as suggested in ESRD treatment choice model.
Methods
We initiated a CKD education clinic (CKDEC) with 3 aims: delay the progression of CKD and onset of dialysis, increase the number of HoD, improve access and timely referral to KT. Individuals who attend the clinic will be educated to avoid the factors and behaviors that can expedite CKD progression and dialysis initiation. Patients will be provided with guidance about controlling underlying medical diseases and introduced to ESRD treatment modalities. We also facilitate their access to obtain permanent access in a timely manner. We are educating the patients about KT and facilitate the appointments & encourage follow up.
Results
209 patients that are CKD IV and V at our outpatient facility & 25 dialysis. Of those, who chose HoD after CKDEC are 14.3%. This is higher than the national rate of 13%. CKDEC improved referral rate to KT and vascular access (Table 1). Many of our patients who started dialysis in 2021-2022 used CVC (71%) after CKDEC, this is lower than the national CVC rate (83%) image 1
Conclusion
CKD education improves HoD rate, referrals to KT and dialysis access among CKD but not ESRD group. we need to continue earlier access to CKD education clinic to continue to improve our outcome measures.
Table 1
| CKDEC transplant referral | CKDEC access referral | NE transplant referral | NE access referral | |
| CKD IV | 42.8% | 23.8% | 2.8% | 2.2% |
| CKD V | 71.4% | 92.8% | 61.3% | 67.7% |
CKDEC: chronic kidney disease education clinic. NE: did not attend CKDEC