The Kidney Failure Risk Equation Score and CKD Care Delivery Measures: A Cross-sectional Study.
Chronic kidney disease
kidney failure risk equation
quality improvement
urine albumin/creatinine ratio
Journal
Kidney medicine
ISSN: 2590-0595
Titre abrégé: Kidney Med
Pays: United States
ID NLM: 101756300
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
entrez:
24
1
2022
pubmed:
25
1
2022
medline:
25
1
2022
Statut:
epublish
Résumé
The 4-variable kidney failure risk equation (KFRE) allows for the prediction of chronic kidney disease (CKD) progression using age, sex, estimated glomerular filtration rate, and urine albumin/creatinine ratio. Electronic health records enable KFRE auto-calculation, and registries allow population-level application. We assessed whether 2-year KFRE score categories are associated with CKD care metrics. Cross-sectional cohort. This study included individuals with CKD in March 2020 who were receiving care within the Partners HealthCare system in Massachusetts. The presence of sufficient data to calculate the KFRE and, among those with a KFRE score, performance on CKD clinical care metrics, including (1) prescription of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker; (2) blood pressure at goal (<140/90 mm Hg) based on clinic measurements; (3) composite metric of hepatitis B virus immunity; (4) composite metric of referral, evaluation, or waitlist status for kidney transplantation; (5) advance directive documentation; (6) yearly influenza vaccination; and (7) pneumonia vaccination. Multivariable logistic regression analysis was used to analyze the association of KFRE score category with CKD care metrics. Of 61,546 patients, 18,272 (30%) had auto-calculated 2-year KFRE scores; the remaining patients lacked KFRE scores because of absent albuminuria assessment. Individuals with a KFRE score were more likely to have a primary care provider or nephrologist. Among patients with 2-year KFRE scores, high-risk patients had increased odds of completing advance directives (OR, 1.52; 95% CI, 1.07-2.17), while low-risk patients had decreased odds of influenza vaccination (OR, 0.85; 95% CI, 0.75-0.97). Patients with moderate- and high-risk KFRE scores had lower odds of having blood pressure at goal (OR, 0.77; 95% CI, 0.61-0.96 and OR, 0.63; 95% CI, 0.44-0.88, respectively). Albuminuria data may have been assessed outside of the Partners system. A higher-risk KFRE score is associated with the delivery of some but not all CKD care measures. An opportunity exists to improve albuminuria measurement.
Identifiants
pubmed: 35072040
doi: 10.1016/j.xkme.2021.08.010
pii: S2590-0595(21)00218-1
pmc: PMC8767093
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100375Informations de copyright
© 2021 The Authors.
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