NKFM and MCRH Partner to Increase Early Detection of Chronic Kidney Disease
The National Kidney Foundation of Michigan (NKFM) is dedicated to preventing kidney disease and improving the quality of life for those affected. The NKFM offers various programs, services, and resources, including medical information, risk factor awareness, and patient support. Through the "Are You the 33%?" campaign, NKFM aims to raise awareness about kidney health and promote early detection and management of chronic kidney disease, especially in high-risk and rural populations. NKFM also offers many resources to help address, educate, and manage chronic diseases among people living in rural communities.
In Michigan, 1 in 7 adults have chronic kidney disease (CKD)1. However, most of them are unaware of it. The aging population, high rates of chronic conditions, and limited access to specialty care puts people in rural areas at greater risk. Rural health providers are essential to increase early detection of CKD and educate their patients to improve outcomes.
CKD is diagnosed using two simple and inexpensive lab tests, the estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR). The eGFR and uACR are strong predictors of CKD progression, end-stage renal disease, and cardiovascular risk and mortality. 2 Testing for CKD should focus on patients with the most common CKD risk factors such as high blood pressure, diabetes, cardiovascular disease, and a family history of CKD. 3,4
Often the uACR is underutilized, though it is an essential part in detecting CKD for people at risk, as albuminuria is often detected before the eGFR drops below 60 mL/min/1.73 m2.3 Early detection of CKD using both uACR and eGFR offers an opportunity to prevent complications before symptoms occur and slow the loss of kidney function over time.3,4
The KDIGO Heat Map below is a tool for staging, risk stratifying and monitoring CKD based on the eGFR and uACR results.4 The grid depicts the risk of progression, morbidity, and mortality by color, from lowest to highest. Green: low risk (if no other markers of kidney disease); Yellow: moderately increased risk; Orange: high risk; Red, very high risk. The boxes also show the recommended frequency of visits and indications for nephrology referral.2
NKFM and the Michigan Center for Rural Health (MCRH) have partnered to educate the rural health network about kidney health, early detection, and treatment.
Since February, NKFM and MCRH are working to increase awareness of the importance of early detection and management of CKD in rural health clinics (RHCs), with a focus on reaching high risk Medicaid-eligible populations. During this “CKD learning collaborative,” four RHCs from McLaren and Aspire Rural Health systems participated in clinical education and developed action plans to integrate CKD testing into their daily workflows. The learning collaborative series spans four sessions aimed at equipping healthcare practitioners and office staff with essential knowledge and tools for effective CKD detection and management. The clinics have made practice changes, such as updating order sets to screen patients with hypertension, using easy-to-read educational materials to educate patients about kidney disease risk, and ensuring clinical documentation of CKD diagnosis. Stay tuned for a new “CKD Rural Health Toolkit” from MCRH for ways to improve CKD care at your location!
For more information on early detection of CKD and free patient education materials, visit: www.nkfm.org/provideredu.
Terri Walters, MHA
Program Specialist II
National Kidney Foundation of Michigan
Anna Agrawal
Communications Coordinator
National Kidney Foundation of Michigan
References:
1. CDC (Centers for Disease Control). Chronic Kidney Disease in the United States, 2023. Chronic Kidney Disease. Published May 6, 2024. https://www.cdc.gov/kidney-disease/php/data-research/index.html
2. Farrell DR, Vassalotti JA. Screening, identifying, and treating chronic kidney disease: why, who, when, how, and what?. BMC Nephrol. 2024;25(1):34. Published 2024 Jan 25. doi:10.1186/s12882-024-03466-5
3. Inker LA, Astor BC, Fox CH, et al. KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD. American Journal of Kidney Diseases. 2014;63(5):713-735. doi:https://doi.org/10.1053/j.ajkd.2014.01.416
4. CKD evaluation and management – KDIGO. Kdigo.org. Accessed June 14, 2024. https://kdigo.org/guidelines/ckd-evaluation-and-management/