Abstract: SA-PO1266
Comparative Implementation Pathways for Measured GFR (mGFR) Adoption Across Nephrology and Oncology
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Ferguson, Gayla, The University of Texas Health Science Center at Houston, Houston, Texas, United States
- Shafi, Tariq, Baylor Scott and White Central Texas, Temple, Texas, United States
- Pezzia, Carla, Baylor Scott and White Central Texas, Temple, Texas, United States
- Gowen, Bailey, Baylor Scott and White Central Texas, Temple, Texas, United States
- Liu, Harry, Baylor Scott and White Central Texas, Temple, Texas, United States
- Tajerian, Amin, Baylor Scott and White Central Texas, Temple, Texas, United States
- Highfield, Linda, Baylor Scott and White Central Texas, Temple, Texas, United States
Background
CKD and cancer frequently coexist. With low GFR, chemotherapy decisions are constrained, toxicity risk increases, and higher rates of therapy discontinuation and mortality exist for cancer patients. KDIGO guidelines recommend GFR measurement for precision dosing and care. However, access to mGFR in the US is limited. No pre implementation studies have evaluated how nephrology or oncology could integrate mGFR into practice.
Methods
We leveraged Baylor Scott & White Health’s ongoing mGFR roll-out as a natural experiment to assess pre-implementation. A combination of surveys, semi-structured interviews, and workflow observation were used to assess determinants from CFIR, COM-B, and SEIPS 3.0. Data from surveys and interviews is ongoing and will be analyzed using descriptive statistics and thematic content analysis.
Results
Study invitation was distributed to 54 people via email with an embedded REDCap link for survey completion and invitation to interview. Preliminary NoMAD domain scores found Cognitive Participation scored highest (4.71/5), indicating strong clinician engagement and willingness to support implementation. Coherence was also high (4.20/5), suggesting respondents understood the purpose and value of mGFR testing. Collective Action scores (4.06/5) reflected generally positive perceptions. Reflexive Monitoring scored lowest (3.92/5), indicating somewhat uncertainty of ongoing evaluation, feedback, and assessment of the intervention’s effectiveness over time. ORIC results demonstrated generally high organizational readiness. Change Commitment scores were high (4.27/5) with Change Efficacy scores slightly lower (4.05/5), suggesting respondents generally believed their teams had the skills, coordination, and organizational support necessary to implement mGFR testing successfully, though some uncertainty regarding operational challenges and sustaining implementation efforts over time. Interviews and workflow observation are ongoing and will be complete prior to the ASN meeting.
Conclusion
To our knowledge, this is the first study evaluating mGFR implementation in the US, and our results will provide a practical framework for broader integration of mGFR into routine clinical care, aligning with KDIGO’s vision that “all nephrologists ideally should therefore have access to at least one method to measure GFR,” and facilitating precision care for patients with CKD and cancer.
Funding
- Private Foundation Support