Closing the gap between evidence and practice in chronic kidney disease

Area of Science:

• Nephrology
• Implementation Science
• Public Health

Background:

• Significant knowledge exists on effective chronic kidney disease (CKD) treatments.
• However, there are major gaps in delivering these evidence-based therapies globally.

Purpose of the Study:

• To highlight the disparity between CKD treatment knowledge and global delivery of care.
• To identify barriers hindering optimal evidence-based nephrology care.
• To advocate for investment in implementation science to bridge these gaps.

Main Methods:

• Review of current evidence on effective CKD therapies.
• Analysis of barriers to evidence-based nephrology care delivery.
• Discussion of the role of implementation science in addressing these barriers.

Main Results:

• Many CKD patients do not fully benefit from blood pressure control, statins, or glycemic management.
• Barriers include limited healthcare access, unaffordable treatments, patient factors, knowledge dissemination issues, and structural impediments.
• Implementation science offers a pathway to cost-effective improvements.

Conclusions:

• There is a critical need to improve the global delivery of evidence-based CKD care.
• Addressing identified barriers through targeted implementation science is essential.
• Increased investment in implementation science can yield significant local and global health benefits for CKD patients.