Abstract: SA-PO0980
Knowledge of Diabetic Kidney Disease Management in Primary Care, Nephrology, and Endocrinology
Session Information
- Educational Research
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
Authors
- Kowalczyk, Nicholas Stanley, The University of Chicago, Chicago, Illinois, United States
- Laiteerapong, Neda, The University of Chicago, Chicago, Illinois, United States
- Saunders, Milda R., The University of Chicago, Chicago, Illinois, United States
Background
KDIGO released new guidelines in the management of diabetic kidney disease (DKD). Studies prior to guidelines showed barriers in knowledge in management of DKD.
Methods
An electronic survey was sent to 365 clinicians in primary care (PC), nephrology, and endocrinology (including residents and fellows) at an urban tertiary academic medical center and its satellite clinics. The survey was developed by 2 PC physicians, 2 nephrologists, and 1 endocrinologist. The survey evaluated knowledge about screening for DKD, the definition of CKD, using the Kidney Failure Risk Equation (KFRE) to decide on referral to nephrology, and the use of renoprotective medications including RAAS, SGLT2i, finerenone, and GLP-1 agonists. Descriptive analyses were performed and logistic models were used to evaluate differences in knowledge based on specialty and level of training.
Results
About 33% (N=120) of potential participants completed the survey. Most participants knew how to screen for DKD (86%) but were less likely to recognize albuminuria as a criteria for CKD (70%), to order cystatin C in a borderline case of CKD (64%), and to understand how to use the KFRE to determine when to refer to nephrology (25%). Compared to non-trainees, residents were less likely to answer those questions correctly (56.3% p=0.04; 46.9% p=0.01; 9.4% p=0.03). All participants recognized that starting an SGLT2i can provide renal and cardiovascular benefit to a patient with advanced CKD (72%), but they were less likely to increase RAAS to maximum dose in persistent albuminuria (47%) with endocrinologists (p=0.01) and primary care clinicians (p=0.03) being less likely to increase RAAS compared to nephrologists. Only 37% recognized finerenone and GLP-1 agonists as potential additional agents in albuminuric DKD, with PC less likely (p=0.001) compared to nephrologists.
Conclusion
Interventions are needed to improve knowledge of new paradigms in the management of DKD including use of cystatin C, the KFRE, and newer medications such as finerenone and GLP-1 agonists in all specialties and levels of training with particular focus on primary care and trainees.
Funding
- NIDDK Support