Abstract: FR-PO0915
Increasing Early Detection of CKD in Patients with Muscular Dystrophy
Session Information
- Pediatric Nephrology: Genetic Diseases, Development, Neonatal Nephrology, Glomerular Diseases, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Phillips, Melonie Anne, Nationwide Children's Hospital, Columbus, Ohio, United States
- Patel, Hiren P., Nationwide Children's Hospital, Columbus, Ohio, United States
Background
Patients with muscular dystrophy (MD) are at higher risk of developing chronic kidney disease (CKD) due to various factors, such as kidney injury from chronic myoglobin exposure. It is common for CKD to go unrecognized in this population because low muscle mass leads to deceptively low creatinine. Cystatin C is a more accurate indicator of kidney function but is not obtained or is obtained infrequently. This can lead to dangerous consequences, such as improper medication choice or dosing. A large population of patients with MD is seen at Nationwide Children’s Hospital, so we created and implemented a quality improvement (QI) project to increase the obtainment of outpatient cystatin C levels in this population.
Methods
We used the Model for Improvement to create a QI project to increase obtainment of cystatin C levels with Plan–Do–Study–Act cycles to implement and evaluate interventions. The MD clinic nurse practitioner team reviewed patient charts prior to clinic visits to determine if the patient had a normal cystatin C level obtained in the last year, and if not, to order it. Additionally, we collaborated with our laboratory team to establish a process of scheduling lab appointments on the day of patient clinic visits.
Results
Mean compliance during our 24-month baseline retrospective data analysis was 64%, with an average of 20 patients per month meeting inclusion criteria. In the eight months since the project has been active, mean compliance has been 75.7%, with an average of 26 patients meeting inclusion criteria. Our highest month to date saw 90% compliance; we have not yet achieved a centerline shift.
Conclusion
Partnerships between nephrology and specialities who care for patients at high risk of developing CKD can lead to appropriate screening for CKD development and determine which patients can benefit from nephrology follow-up. Future directions include leveraging tools in the electronic medical record to alert providers that a cystatin C level is indicated for a patient and implementing in other clinics whose patients would benefit from CKD screening with a cystatin C level, such as our myelomeningocele clinic.