A Population-Based Analysis of Quality Indicators in CKD

Area of Science:

• Nephrology
• Public Health
• Health Services Research

Background:

• Chronic kidney disease (CKD) awareness is lower than for other chronic diseases like diabetes.
• This low awareness contributes to underutilization of preventive measures and testing for CKD.
• Quality of care for individuals with or at risk of CKD needs thorough evaluation.

Purpose of the Study:

• To assess the quality of healthcare delivered to individuals diagnosed with CKD.
• To evaluate the quality of care for individuals at risk of developing CKD.
• To identify gaps in CKD management and preventive strategies.

Main Methods:

• Population-based analysis of Albertans with estimated glomerular filtration rate (eGFR) 15-59 ml/min per 1.73 m².
• Inclusion of patients with diabetes within the study period (April 1, 2011 - March 31, 2012).
• Assessment of quality indicators including albuminuria testing, preventive medication use, and screening tests like urine albumin-to-creatinine ratio and serum creatinine.

Main Results:

• Only 17.0% of non-diabetic CKD patients (eGFR 15-59) had albuminuria testing, versus 64.2% of diabetic patients.
• Guideline-concordant medication use (ACE inhibitors/ARBs) was lower in non-diabetic CKD patients (63.2%) compared to diabetic patients (82.1%).
• Statin use was significantly lower in non-diabetic CKD patients (39.2%) than diabetic patients (64.6%).

Conclusions:

• Significant gaps in CKD care quality were identified, particularly for patients without diabetes.
• Major deficiencies include guideline-based medication prescription for CKD patients and albuminuria screening for diabetic patients.
• Measuring health system performance is crucial for initiating quality improvement processes in CKD care.