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Friday, March 3, 2023

Two simple tests can help diagnose kidney disease

According to the Centers for Disease Control & Prevention, 37 million American adults are estimated to have chronic kidney disease (CKD), with 90% unaware of the condition.


Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity, history of acute kidney injury, and family history. CKD puts patients at increased risk for cardiovascular events and progression to kidney failure and death. By screening high risk populations for CKD, primary care providers are poised to slow CKD progression and reduce end stage kidney disease.


The National Committee for Quality Assurance (NCQA) recognizes the importance of this screening through the HEDIS measureKidney Health Evaluation for Patients with Diabetes,” which tracks the rate of annual screening in adults with type 1 or 2 diabetes. Early detection of CKD offers an opportunity to prevent complications before symptoms occur and to slow loss of kidney function over time.


CKD is diagnosed by two widely available and inexpensive tests:


  • estimated glomerular filtration rate (eGFR)
  • urine albumin-creatinine ratio (uACR)


The eGFR and uACR tests are independent and complementary predictors of important clinical outcomes including CKD progression, end-stage renal disease, cardiovascular mortality, and all-cause mortality. Both tests are important as albuminuria is often detected before the eGFR drops below 60 mL/min/1.73 m2, thus allowing earlier CKD diagnosis and intervention.


However, uACR testing in people at risk for CKD remains underutilized. The heat map included here simplifies staging of CKD based on these two tests. For tips on communicating CKD test results and explaining a heat map to patients, view this helpful document from the National Kidney Foundation.


When CKD is diagnosed early, primary care physicians are more likely to prescribe ACE inhibitors or Angiotensin Receptor Blockers when indicated, and to refer patients to a nephrologist when appropriate. 


Source: National Kidney Foundation of Michigan (NKFM)

Education program recordings available to view

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If you missed out on attending one of The Physician Alliance's education webinars, don't worry! Most webinars are recorded and posted to TPA's website.


Webinar topic examples include coding, compliance, creating a flu vaccine program and more. Find a list of webinar recordings here (you will need to log into TPA's member portal to view the recordings).


Don't forget to check TPA's website for upcoming education programs.

Tips for using your voice for positive change

Understanding policy issues that impact patients and physicians is an important opportunity for healthcare professionals to help make positive change. Public policy affects much of healthcare, such as prior authorization, access to care, physician reimbursement, scope of care and more.


Advocacy is an effective and important way to bring about change in communities and society. Many people think advocacy is only lobbying legislators but that’s just one part of advocacy. Advocacy includes a range of activities, from public education to research and more.


Here are some ways to get involved in advocacy:



  • Find an organization that aligns with your interests. Consider what you are most passionate about and where you would like to put your time. There are general focused physician organizations, such as Michigan State Medical Society and American Medical Association. Specialty-specific societies may focus more on issues impacting a specific medical discipline. Disease-related organizations work for changes to care, treatment, research and more related to specific diseases impacting patients (and access to care).


  • Determine how you want to get involved. Ask the organization what their needs are to help determine how you would like to be involved. Organizations are always in need of funding to support their efforts, but don’t discount the power of your voice and time too. Grassroots advocacy makes a major impact on changing behaviors, attitudes, and legislation. Most organizations offer training opportunities to get new volunteers comfortable and engaged. Volunteer opportunities may include making phone calls, collecting petitions, writing letters to the editor, promoting and attending events, meeting with legislators and civic leaders and more.


  • Sign up for action alerts. Once you find an organization (or many) that aligns with your interests, sign up for emails and action alerts. These will keep you updated on current events and important issues and topics. An action alert may ask that you send an email or make a phone call to your representatives – most organizations provide pre-written email and phone scripts, making it very quick and easy to take very important action. Responding to calls to action is easy and impactful on advocacy campaigns.


  • Educate yourself. You don’t have to be an expert on every issue, but at least know the basics of a topic before sharing content. Maybe choose two or three areas that motivate you and learn about those. Identify different viewpoints too so you understand how to respond to all views. If you’re searching the internet, make sure you land on credible sources.


  • Know your elected officials. Local, state, and federal legislators represent YOU and make decisions affecting your life, whether or not you voted for them. Be familiar with their interests and votes. Legislators often take their constituents’ views into consideration before voting or acting on specific issues. Sign up for your legislators’ electronic newsletters and follow them on social media. Find your state representative here. Find your federal representatives here.


This article first appeared in the fall 2022 issue of The Physician Alliance's The Pulse quarterly newsletter. Read the full article here.

Current healthcare news

After Staying Away During Pandemic, Doctors Return to Lobby Congress, Kaiser Health News

COVID-driven drop in cancer screenings didn't result in more new cases, Axios

Hospital-Acquired Pneumonia Is Killing Patients, Medscape

Fixing the health care worker shortage may be something Congress can agree on, NPR

Only 5.7% of US doctors are Black, shortage harms public health, CNN

Ways you can save

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