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Updated: Jan 30, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Closing the gap between evidence and practice in chronic kidney disease
Meg J Jardine1,2, Bertram Kasiske3,4, Dwomoa Adu5
1Renal & Metabolic Division, The George Institute for Global Health, University of New South Wales Sydney, New South Wales, Australia.
Insights
Effective chronic kidney disease (CKD) treatments are underutilized globally. Addressing barriers like healthcare access and treatment affordability through implementation science can improve evidence-based nephrology care worldwide.
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.
Abstract:
There are major gaps between our growing knowledge of effective treatments for chronic kidney disease (CKD), and the delivery of evidence-based therapies to populations around the world. Although there remains a need for new, effective therapies, current evidence suggests that many patients with CKD are yet to fully realize the benefits of blood pressure-lowering drugs (with and without reducing proteinuria with renin-angiotensin system blockade), wider use of statins to reduce atherosclerotic cardiovascular disease events, and better glycemic control in both type 1 and type 2 diabetes. There are many barriers to optimizing evidence-based nephrology care around the world, including access to health care, affordability of treatments, consumer attitudes and circumstances, the dissemination of appropriate knowledge, the availability of expertise and structural impediments in the delivery of health care. Further investment in implementation science that addresses the major barriers to effective care in a cost-effective manner could yield both local and global benefits.
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