Chronic kidney disease (CKD) is a variable condition that can progress slowly, quickly or hardly at all over the course of someone’s life. Identifying the people who may one day develop more severe kidney disease is critical though – with the right interventions, it’s possible to slow the progression of kidney disease by up to 50 per cent. This is equivalent to doubling the amount of time before a person may need dialysis or a transplant.
As part of a study funded by Can-SOLVE CKD, one team of researchers is exploring a new way of identifying CKD patients who are at high risk of disease progression. At the heart of their work is a simple equation for predicting the risk of disease progression.
Dr. Navdeep Tangri, a nephrologist at the University of Manitoba, first published evidence of the Kidney Failure Risk Equation’s ability to predict progression to kidney failure in 2011. The equation is calculated based on the age and sex of a patient, as well as results from special blood and urine tests that indicate kidney function. For example, urine albumin tests are important for understanding the current state of a person’s kidney disease and the risk of it becoming more severe.
However, Dr. Tangri notes that, while many nephrologists may order these tests for their CKD patients, many primary care physicians are not aware of the importance of these tests and do not routinely order them. This is a problem, since many people living with CKD do not have a nephrologist and rely on their primary care doctor for disease monitoring and treatment.
“Until we empower primary care physicians, we can’t have the maximum impact on disease [management],” emphasizes Dr. Tangri. “So part of our research project is to show primary care providers that they can [order the appropriate tests and] use the equation to identify which of their patients are of high risk and which patients are low risk of disease progression.”
His team, in partnership with the Canadian Primary Care Sentinel Surveillance Network, is coordinating a large-scale study to evaluate the equation in clinics across Alberta and Manitoba. Half of the primary care providers in the study are given information about the Kidney Failure Risk Equation and how to use it in the clinic, while the other half are not.
“What we’re hoping is that these physicians who come to these presentations and receive [information about the equation] tend to perpetuate that forward in their network. And hopefully we see big improvements in appropriate testing and management of chronic kidney disease,” explains Dr. Tangri.
The study is halfway complete, with data still being collected and analyzed. However, both Dr. Tangri and his colleague Oksana Harasemiw say they are observing early, positive results as they interact with doctors in the clinics.
“It’s really great to see the impact that you have, right then and there in the clinic,” says Harasemiw, a research coordinator on the project. “I’m seeing the real-world impact in real-time.”
The Kidney Failure Risk Equation is not just proving to be popular among primary care doctors participating in the study, but also the public. You can visit the website for the research project, and calculate your personal risk using the online calculator: https://kidneyfailurerisk.com/