Kidney Week

Abstract: TH-PO0609

Optimizing CKD Management by Leveraging Electronic Medical Record Clinical Support Tools

Session Information

• CKD: Clinical - Guidelines, Biomarkers, Progression, Procedures, Outcomes, and More
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Lee, Deborah, University of California San Francisco, San Francisco, California, United States

Deborah Lee, MD

• Shi, Kevin Xin, University of California San Francisco, San Francisco, California, United States

Kevin Xin Shi, MD

• Gupta, Kashvi, University of California San Francisco, San Francisco, California, United States

Kashvi Gupta, MD, MPH

• Vaidya, Neha Vijay, University of California San Francisco, San Francisco, California, United States

Neha Vijay Vaidya, MD

• Kattubadi, Ayeesha, University of California San Francisco, San Francisco, California, United States

Ayeesha Kattubadi, MBBS

• Ravi, Divya, University of California San Francisco, San Francisco, California, United States

Divya Ravi, MBBS

• Nguyen, Thai, University of California San Francisco, San Francisco, California, United States

Thai Nguyen, DO

• Stewart, Erik, University of California San Francisco, San Francisco, California, United States

Erik Stewart

• Kwong, Yuenting Diana, University of California San Francisco, San Francisco, California, United States

Yuenting Diana Kwong, MD, MAS, FASN

• Lo, Lowell J., University of California San Francisco, San Francisco, California, United States

Lowell J. Lo, MD

Background

Electronic medical record (EMR)-based clinical support tools can empower providers to deliver evidence-based management of chronic kidney disease (CKD), but they are often underutilized. We describe a fellow-led quality improvement initiative at a nephrology clinic leveraging EMR tools to optimize sodium-glucose cotransporter-2 inhibitors (SGLT2i) utilization and blood pressure control.

Methods

During 2024-2025, the initiative focused on increasing SGLT2i utilization. The CKD Metric Dashboard identified patients with eGFR ≥25 mL/min/1.73m², systolic blood pressure (SBP) >100 mmHg, and urine albumin-creatinine ratio >30 mg/g as potential candidates. Interventions included implementing Best Practice Advisory (BPA) alerts, monthly reminders identifying eligible patients before visits, and tools to document reasons for deferring SGLT2i in the EMR.

During 2025-2026, the initiative focused on blood pressure control. The CKD Metric Dashboard identified patients younger than 65 years with SBP >130 mmHg. Interventions focused on improving the quality of blood pressure data by implementing standardized blood pressure measurement protocols, integrating home blood pressure data into the EMR, and flagging patients with elevated blood pressure before their visits. To improve participation and reduce alert fatigue, the team incorporated surveys to better understand provider barriers, workflow challenges, and perceptions of the CKD Metric Dashboard and BPA alerts.

Results

Instituting a fellow-guided panel management in conjunction with the CKD Metric Dashboard has improved SGLT2i utilization from 31% to 40% and blood pressure control among patients less than age 65 from 68% to 72%. 46% of the providers in nephrology clinic reported actively using the CKD Metric Dashboard.

Conclusion

Leveraging EMR-based clinical support tools can improve delivery of guideline-directed CKD care. CKD Metric Dashboard combined with fellow-led panel management improved SGLT2i utilization and blood pressure control in a nephrology clinic. This scalable model may be extended to additional CKD quality metrics and other subspecialty practices. Future efforts should focus on improving provider engagement and reducing alert fatigue in increasingly demanding clinical environments.