Abstract: SA-PO0451
Simple Interventions, Measurable Impact: Improving Nephropathy Screening Rates in Patients with Diabetes in Primary Care Clinic, a Quality Improvement Project
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
- Hariharan, Nithesh, New York City Health and Hospitals Jacobi, New York, New York, United States
- Chowdhury, Samsul I., New York City Health and Hospitals Jacobi, New York, New York, United States
- Behera, Ritika, New York City Health and Hospitals Jacobi, New York, New York, United States
- Dhakal, Rhea, New York City Health and Hospitals Jacobi, New York, New York, United States
- Chandra Shekar, Pooja, New York City Health and Hospitals Jacobi, New York, New York, United States
- Kong, Deqi, New York City Health and Hospitals Jacobi, New York, New York, United States
- Suresh, Priyadarshini, New York City Health and Hospitals Jacobi, New York, New York, United States
- Takchi, Andrew, New York City Health and Hospitals Jacobi, New York, New York, United States
Background
Diabetes is a leading cause of chronic kidney disease (CKD), with one in three individuals in high-income countries developing CKD. Early identification is critical, as timely interventions can delay progression. KDIGO recommends annual nephropathy screening for all patients with diabetes, using both urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). Despite these recommendations, screening rates remain suboptimal. Our aim was to increase the percentage of patients with diabetes seen at the Primary Care who completed annual nephropathy screening by 5 % from baseline (November 2025) by March 30th, 2026
Methods
Patients aged 23–75 years with diabetes seen monthly in primary care were included. We assessed completion of nephropathy screening within one year of each PCP visit. Pre-intervention data spanned November 2025 through January 2026. The intervention, implemented in February 2026, involved placing urine collection cups directly in examination rooms. The process measure was the number of patients with a documented UACR result within one year of their visit. The outcome measure was the monthly percentage of patients completing nephropathy screening. Retinal screening rates were tracked as a balancing measure. Screening outcomes were stratified by primary language (English vs. non-English) to assess for disparities. Statistical significance was evaluated using a two-proportion chi-square test.
Results
The number of diabetic patients seen increased from 726 (Nov 2025) to 1,085 (March 2026). Nephropathy screening rates improved from 57.9% to 66.6% in March 2026. Comparing pre- to post-intervention periods, screening rates improved from 70.5% (1,230/1,744) to 74.5% (2,311/3,104) (p<0.001). UACR completion rose from 476 to 891 over the same period. Retinal screening increased from 379 to 679, confirming that it had no adverse impact on other care. Equity analysis showed pre-intervention rates of 69.0% among English-speaking and 75.2% among non-English-speaking patients. Post-intervention, rates improved to 74.3% and 77.3%.
Conclusion
A low-cost intervention significantly improved nephropathy screening rates among patients with diabetes. While both language groups improved, persistent disparities highlight the need for targeted, equity-focused strategies to guide future interventions.
Acknowledgment
This project was determined to be a quality improvement initiative and was exempt from IRB review. The authors wish to thank Dr. Kimberly Cartmill for mentorship and guidance throughout this project.