Abstract: SA-PO0458
A Structured Provider Education Program Increased Guideline-Directed Medical Therapy (GDMT) for CKD and Reduced Hyperkalemia in a Network of Nephrology Practices
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Kwon, Katherine Westin, Panoramic Health, Tempe, Arizona, United States
- Mooney, Ann, Panoramic Health, Tempe, Arizona, United States
- Eckhardt, Douglas, Panoramic Health, Tempe, Arizona, United States
- Pu, Jie, Panoramic Health, Tempe, Arizona, United States
- Marcus, Roy G., Panoramic Health, Tempe, Arizona, United States
Background
GDMT has a prominent role in the 2024 KDIGO CKD guidelines to reduce CKD progression and reduce the risk of hospitalization. We designed an initiative to increase the use of GDMT in 273,475 CKD patients in a network of nephrology practices and measured the change in hyperkalemia (HK) as GDMT increased.
Methods
We measured GDMT use in all CKD patients seen in the office during a 4-month baseline period from 3/24-6/24. We educated physicians on 2024 KDIGO GDMT guidelines including the management of HK, the published risk of RASi downtitration or discontinuation, the low genitourinary infection risk in the major SGLT2i trials and infection prevention strategies, the KDIGO UACR monitoring recommendations and GDMT affordability information. Practices received GDMT use rates by provider on a regular cadence for peer benchmarking. Follow-up GDMT was measured during the 4-month period from 12/25-3/26. HK was defined as potassium (K+) > 5.0 and severe HK was defined as K+ > 6.0. HK prevalence was measured during the baseline and follow-up period.
Results
Between baseline and follow up, GDMT use increased as shown in the table below with significant increases in SGLT2i, RASi, and nsMRA. sMRA usage also significantly increased. K+ binder use significantly increased as well. HK decreased from 21.0% to 15.8% (p<0.001) and severe HK decreased from 0.8% to 0.5%. (Table 1)
Conclusion
A structured implementation process was associated with increased GDMT utilization in CKD patients without an increase in HK rates; instead, the proportion of patients with HK declined. Increased use of SGLT2i and K binders may have contributed to the observed reduction in HK and allowed optimization of GDMT.
Funding
- Commercial Support – AstraZeneca