Early Identification and Action in CKD
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chronic Kidney Disease
- Sponsor
- Geisinger Clinic
- Enrollment
- 47
- Locations
- 1
- Primary Endpoint
- Screening Urinary Albumin Excretion
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Chronic kidney disease (CKD) is highly prevalent and associated with significantly increased risk of cardiovascular morbidity and end-stage renal disease. Evidence from randomized clinical trials suggests that treating urinary albumin excretion (UAE), dyslipidemia, and hypertension will reduce these risks. Unfortunately, less than 30% of the CKD population is screened and treated according to recommended guidelines. Using a cluster-randomized, controlled design and clinic-embedded pharmacists, this pilot pragmatic trial will randomize 6 Geisinger primary care clinics (72 patients) to usual care (group 1) or a pharmacist-directed "CKD Action Plan" (group 2). Determining the impact of the CKD Action Plan on screening and treatment guideline adherence is the primary goal of this pilot study.
Investigators
Alexander Chang
Clinical Investigator
Geisinger Clinic
Eligibility Criteria
Inclusion Criteria
- •18 years of age or older
- •eGFRCR value between 45-59 ml/min/1.73m2 in the prior 12 months
- •scheduled laboratory appointment for serum creatinine testing within the next 30 days
- •average systolic or diastolic blood pressure reading of at least 150 or 85 mm Hg, respectively, during the prior 12 months.
Exclusion Criteria
- •fewer than 2 blood pressure readings in the prior 12 months,
- •pregnancy
- •current hospitalization
- •life expectancy less than 6 months as determined by the study investigators
Outcomes
Primary Outcomes
Screening Urinary Albumin Excretion
Time Frame: At 12 months
Completed test for urine albumin/creatinine (or urine protein/creatinine)
Secondary Outcomes
- Blood Pressure--II(Average of all blood pressures within 12 month study period)
- Blood Pressure Control-1(Average of last two readings prior to 12 months post-enrollment)
- Blood Pressure--III(at 12 months post enrollment)
- Symptomatic Adverse Drug Event(At 12 months post-enrollment)
- Statin Treatment(Within 12 months of enrollment)
- Biochemical Surveillance(two weeks after initiation or titration of ACEI or ARB)
- Patient and Provider Satisfaction(9-12 months post study start date)
- Cystatin C Supplementary Screening(within 12 months of enrollment date)
- Dyslipidemia Screening(At least once after eGFR < 60 ml/min)
- ACEI or ARB Treatment if urine ACR is > 30 mg/g (diabetic) or > 300 mg/g (non-diabetic)(within 12 months of enrollment date)