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Perspectives in Managing Kidney Disease and Atherosclerotic Cardiovascular Disease
Tarlan Namvar1, Matthew A Cavender2, Eden Miller3
1Novo Nordisk Inc, Plainsboro, New Jersey, USA.
Insights
Healthcare providers often fail to discuss risks of chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) with patients, despite their known link. Nephrologists are key to improving patient understanding and management of these interconnected conditions.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) are closely linked with cardiometabolic conditions.
- Limited data exists on patient and provider perceptions of this clinical overlap.
Purpose of the Study:
- To evaluate healthcare provider (HCP) and patient attitudes regarding CKD and ASCVD risk, diagnosis, and management.
- To identify gaps in communication and education between patients and providers concerning these linked diseases.
Main Methods:
- Cross-sectional surveys conducted in the USA (May-June 2021).
- Participants included 58 nephrologists, 74 cardiologists, and 195 patients with self-reported CKD and ASCVD.
Main Results:
- Most nephrologists recognized cardiometabolic comorbidities increase CKD risk, but only 52% discussed CKD risk with patients.
- Only 35% of patients reported their HCP discussed how other conditions impact CKD development.
- While 83% of nephrologists recommended lifestyle changes, only 53% of patients reported adherence.
Conclusions:
- HCPs do not routinely educate patients on the bidirectional relationship between CKD and ASCVD.
- Nephrologists are well-positioned to educate patients on cardiorenal health, risk mitigation, and treatment strategies.
- Improved patient-provider communication is crucial for managing the interplay between CKD and cardiovascular health.
Introduction:
Chronic kidney disease (CKD) and atherosclerotic cardiovascular disease (ASCVD) share a complex and dependent link with each other and other cardiometabolic conditions. Currently, there is insufficient data regarding patient and provider perceptions about this important clinical overlap. This study sought to evaluate healthcare provider (HCP) and patient attitudes and perceptions about CKD and ASCVD, including risk, diagnosis, and management of both conditions.
Methods:
Cross-sectional surveys of 58 nephrologists and 74 cardiologists who treat patients with CKD and ASCVD and 195 patients who self-reported having CKD and ASCVD were conducted in the USA between May and June 2021.
Results:
Most nephrologists agreed that the presence of cardiometabolic comorbidities increased patients' risk of developing CKD; 86% agreed that type 2 diabetes increased the risk, and 67% agreed that ASCVD increased the risk. However, only 52% of the nephrologists reported they typically discuss the risk of developing CKD with patients prior to diagnosing them. Slightly more than one-third of patients (35%) reported their HCP discussed other conditions' impact on the development of CKD; of all HCPs surveyed, nephrologists were the least likely to discuss CKD risk with their patients. Most nephrologists (83%) also reported they recommended lifestyle modification to patients; however, only about half of patients (53%) reported they were currently using a lifestyle change to treat CKD and/or ASCVD.
Conclusion:
Although CKD and ASCVD are known to have a bidirectional relationship, HCPs in our study did not report routinely educating patients about the risk of developing one or both conditions. As HCPs with perhaps the deepest understanding of the interplay between CKD and cardiorenal comorbidities, nephrologists are well positioned to help patients understand the link between cardiovascular and renal health, help identify strategies to limit risk, and appropriately treat the conditions.
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