Early Identification and Action in CKD

Early Identification and Action in CKD

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.

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