Leveraging Lab Data and Risk Prediction to Improve Kidney Care – BC Renal PWR (March 2025) скачать в хорошем качестве

Leveraging Lab Data and Risk Prediction to Improve Kidney Care – BC Renal PWR (March 2025)

Dr. Navdeep Tangri presents his talk, “Moving Upstream: Leveraging Lab Data and Risk Prediction to Improve CKD Care,” as part of BC Renal and UBC’s province-wide rounds. 0:04:00 – Predicting CKD Progression Risk Dr. Tangri begins by noting that chronic kidney disease (CKD) diagnoses and care has traditionally been based on eGFR, but it’s important to account for other factors as well, such as creatine. As part of his research, Tangri has created the Kidney Failure Risk Equation (KFRE) for predicting individual patients’ risk of CKD progression. KDIGO guidelines currently recommend using the KFRE, and Dr. Tangri highlights the different ways in which the equation is used internationally, including in Germany, the US and the UK. 0:11:00 – Vascular Access Timing Tangri then discusses how the KFE can be used to support decision-making on when to time vascular access creation. 0:12:00 – Early Intervention Dr. Tangri provides case examples of CKD patients and when early intervention should be considered. He notes that early intervention not just delays the need for dialysis, but also reduces risk of cardiovascular complications. He then highlights a new tool available on actearlyonkidney.com, which allows people to see predicted outcomes based on which treatment they receive. Notably, late intervention with multi-drug regimen may delay dialysis by about 14 years, but early intervention could delay the need for dialysis by 29 years. 0:17:00 – Care and Risk Dr. Tangri notes that care is often not aligned with a person’s individual risk, where too often high-risk patients are not receiving treatments to slow their CKD progression. He points out that, in patients at high risk of experiencing a cardiovascular event, 1 in 4 of these events could be prevented with the appropriate treatment. 0:29:00 – Integrating risk-based care into workflow Dr. Tangri present a clinical decision support tool to ensure providers order the right tests and offer the right interventions. He notes that moderate and low risk patients may receive one or two therapies, whereas those at highest risk may need more interventions and earlier referral to a nephrologist. Dr. Tangri notes that some doctors are not prescribing therapy when it’s indicated, but this problem is ameliorated when high-risk patients are specifically flagged (for example suing the KFRE). 0:37:00 – Other risk models Dr. Tangri briefly highlights several other existing CKD risk models, as well as all cause mortality models. However, he cautions that all cause mortality models may not be accurate enough or appropriate for individual decision-making. He highlights efforts to create a new tool for predicting outcomes after nephrectomies, as well as a new tool for predicting cardiovascular risk. 0:42:00 – Summary and Q&A Dr. Tangri provides an overview of his key points before taking questions from the audience.