Kidney Disease Research Updates
Winter 2007

NIDDK News

NKDEP Sets Priorities for Coming Year

Program Director Stresses Importance of eGFR and Education in Improving CKD Care

Helping clinical generalists improve care for people with chronic kidney disease (CKD) is a key goal for the National Kidney Disease Education Program (NKDEP) in the coming year, according to Program Director Andrew Narva, M.D. Narva outlined program goals for NKDEP coordinating panel members during an October 20, 2006, panel meeting.

“We need to teach primary care providers that taking care of CKD patients is routine––that CKD is part of primary care,” said Narva, a veteran of the Indian Health Service Kidney Disease Program. “The NKDEP can be a change agent for facilitating improved care for people with CKD.”

To achieve this goal, the NKDEP must help define collaboration between primary care providers and nephrologists and help primary care providers learn to identify who’s at greatest risk for progressive CKD, according to Narva. The NKDEP also needs to translate the public health model, which includes CKD for primary care providers, Narva said.

The 2007 NKDEP objectives Narva identified are to

• help primary care providers better assess and treat CKD
• help all health professionals better educate patients about CKD, particularly in at-risk communities, by creating and distributing education tools
• improve diagnostic tools to assess kidney function by making routine estimated glomerular filtration rate (eGFR) reporting universal
• improve coordination of the Federal response to CKD by serving as a clearinghouse for information and ideas about how the Federal Government is responding—and can respond—to CKD

eGFR Progress

During the meeting, coordinating panel members acknowledged the NKDEP’s progress in encouraging laboratories to report eGFR. The NKDEP is currently fielding a survey to determine how many U.S. laboratories have adopted this desired practice. Narva said over the next year, the NKDEP will work to help physicians use eGFR more consistently and appropriately.

Emerging CKD Trends

In a lunch presentation, Paul Eggers, Ph.D., program director for Kidney and Urology Epidemiology at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), said that while CKD rates for African Americans and Caucasians are the same, end-stage renal disease (ESRD) rates for African Americans are four times higher––and researchers are unsure why.

Eggers also reported that the incidence of ESRD has stabilized since 2000, which may be due to better treatment of CKD, particularly among people with diabetes. Eggers pointed out that even small decreases in ESRD incidence can have a big economic impact because each person with ESRD costs Medicare about $65,000 annually.

Collaborating Partners

Representatives of several external organizations identified opportunities to collaborate with the NKDEP, such as

• developing joint publications and educational tools for health professionals
• publishing NKDEP guest articles in the organizations’ magazines and newsletters
• having the NKDEP give presentations at meetings and conferences
• promoting dietary interventions through NKDEP materials
• sharing information and website links
• extending messages and materials about CKD to pediatric populations

The group expressed interest in learning about the NIDDK’s childhood obesity programs at the next NKDEP meeting.

NIH Publication No. 07–4531
March 2007

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