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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Improving the understanding, detection, and management of kidney disease.

Professional Education & Outreach

This section describes education and outreach to health professionals of the Federal government related to chronic kidney disease.

Centers for Disease Control and Prevention (CDC)

The Kidney Disease Initiative is designed to provide public health strategies for promoting kidney health. To help accomplish this goal, CDC convened a consensus conference of kidney disease experts and other stakeholders to establish priorities and strategies in the public health approach to kidney disease prevention and control. For example, CDC hosted a conference in March 2007 to discuss comprehensive public health strategies for preventing the development and progression of chronic kidney disease (CKD). Attendees included representatives from the U.S. Department of Health and Human Service agencies, universities, private and public institutions, and national organizations. The meeting summary with recommendations and the proceedings were published in the March 2009 issue and supplement of the American Journal of Kidney Disease.

CDC published articles related to CKD in the United States in its Morbidity and Mortality Weekly Report.

Contact Information
Nilka Rios Burrows, MT, MPH
Epidemiologist, CDC Division of Diabetes Translation
Phone: 770–488–1057
Email: NBurrows@cdc.gov
Web: www.cdc.gov/diabetes/projects/kidney.htm

The National Chronic Kidney Disease Fact Sheet 2010 provides information on prevalence, health consequences and resources on chronic kidney disease. The fact sheet provides statistics on CKD and kidney failure by age, sex and race/ethnicity, and offers information on risk factors and treatment.

The factsheet is a collaborative effort of CDC, other federal agencies, universities and nonprofit organizations that provide information for the public, kidney advocates and researchers. The fact sheet is not subject to copyright restrictions, and can be duplicated, adapted and distributed freely.

For more information on the chronic kidney disease initiative and to view the fact sheet, please visit http://www.cdc.gov/diabetes/pubs/pdf/kidney_Factsheet.pdf pdf icon (252K).

Contact Information
Sharon Saydah, PhD
LCDR USPHS
Senior Scientist, CDC, Division of Diabetes Translation
Phone: 301-458-4183
Email: SSaydah@cdc.gov
Web: www.cdc.gov/diabetes/pubs/pdf/kidney_Factsheet.pdf pdf icon (252K).

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Centers for Medicare & Medicaid Services (CMS)

The recently concluded CMS 9th Statement of Work (SOW) for Medicare's Quality Improvement Organizations (QIOs) focused on improving the quality, safety, and efficiency of health care services delivered to Medicare beneficiaries. One quality improvement effort required of the QIOs was to reduce the progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD). Each QIO was required to:

  1. Focus on three clinical areas, each with a corresponding clinical measure. These areas included detection of CKD in diabetic beneficiaries; appropriate medication treatment, such as angiotensin converting-enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) to slow the progression of CKD; and adequate counseling prior to initiation of dialysis as evidenced by placement of an arteriovenous (AV) fistula for hemodialysis patients.
  2. Use collaboration as a means of achieving sustainable CKD system level changes. All QIOs were required to monitor the effect of their CKD interventions on disparities and take immediate corrective action if disparities in care are increasing. QIOs could opt to engage in the following three optional tasks: supporting companion CMS quality initiatives, improving CKD care via electronic health records, and decreasing CKD care disparities identified in their state.

CMS' goal was to make sure that the QIOs were providing CMS beneficiaries with the best quality of care through the use of available tools as they worked with consumers, primary care providers, hospitals, and other caregivers to refine the nation's care delivery systems. QIOs began work on the CKD quality initiative in August 2008 and concluded in June 2011.

Other activities included the coordination of educational efforts to primary care providers and laboratories to encourage the reporting of eGFR testing to aid in early detection of CKD.

Contact Information
Yvette Williams
Phone: 410-786-6844
Email: Yvette.williams@cms.hhs.gov

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Department of Defense (DoD)

The DoD, in collaboration with the Veteran's Administration (VA), created the first evidenced based clinical practice guideline pertaining to the management of chronic kidney disease within the primary care setting in the US. The VA/DoD chronic kidney disease (CKD) guideline, initially issued in 2001, was recently revised and reissued in 2008 to reflect current research.

DoD has been actively collaborating with NKDEP since 2009 in the development of healthcare provider education materials pertaining to CKD. The purpose of such efforts is to promote provider understanding of CKD and its treatment, and foster adoption and implementation of the VA/DoD CKD clinical practice guideline. These materials will be widely available to DoD primary care and specialty care providers via the Army Medical Department CPG shopping cart and website at https://www.qmo.amedd.army.mil. Continuing education programs for physicians, advanced practice nurses, physician assistants, nutrition professionals, pharmacists, and laboratory professionals are available. The VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease has also developed a concise summary of evidence-based recommendations on treatment of CKD and complications.

DoD also promotes case management of CKD within their systems. An annual Case Management Society of America meeting is available and open to any health professional who is interested and has the support of his/her supervisor to implement change.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

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Health Resources and Services Administration (HRSA)

HRSA supported a series of Organ Donation Breakthrough Collaboratives from 2003 to 2008 to disseminate rapidly practices that proved effective in increasing the number and utilization of donor organs. The Collaborative series included participation of the organ procurement organizations (OPOs), donor hospitals, and transplant programs throughout the United States.. As best practices became integrated in organizational processes, this unified effort evolved into the Donation and Transplantation Community of Practice (DTCP). The DTCP is working to institutionalize donation and transplantation best practices through partnership, shared accountability, and effective leadership. Partners now include OPOs, hospitals, transplant centers, donor designation teams, and others who have an impact on organ donation and transplantation. From 2003 to December 2010, national performance on the Collaborative conversion rate (a measure reflecting the proportion of possible donors that become actual donors) has increased from 54.4 percent to 74.97 percent.

HRSA is also launching a Primary Care Project to target and encourage primary care physicians and their professional staff to engage in discussions about organ donation with their patients. This initiative is based on survey data suggesting that the American public feels organ donation is a health care issue and that the primary care doctor is the professional with whom they want to discuss it. Materials for this initiative will include posters, table top displays, informational cards, and question and answer cards for physician and staff.

Contact Information
Richard Durbin
Acting Director, Division of Transplantation
Phone: 301–443–6804
Email: RDurbin@hrsa.gov
Web: www.organdonor.gov

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Indian Health Service (IHS)

The IHS Kidney Disease Program implements continuing education programs for physicians, advanced practice nurses, physicians assistants, nutrition professionals, pharmacists, and laboratory professionals. IHS has also developed concise summaries of evidence-based guidelines on treatment of chronic kidney disease (CKD) and complications, including Indian Health Diabetes Best Practices: Chronic Kidney Disease and Diabetes. IHS has also published a collection of 13 brief articles describing a primary care approach to how to treat a patient with CKD.

The program also promotes case management of CKD within the diabetes program. An annual three-day CKD case-management workshop was established and is open to any health professional who is interested and has the support of his/her supervisor to implement change. Additionally, several CKD case-management models, coordinated by a variety of health care professionals, were established throughout IHS. IHS also offers clinical guidelines, protocols for patient education, and treatment protocols for anemia, which are available online for health professionals to facilitate implementation of care.

Contact Information
Andrew S. Narva, MD, FACP, FASN
Chief Clinical Consultant for Nephrology
Phone: 301-594-8864
Email: narvaa@niddk.nih.gov
Web: www.ihs.gov/MedicalPrograms/Diabetes/index.cfm?module=home

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

The National Kidney Disease Education Program (NKDEP) provides information, tools, and materials to a variety of health professionals to improve their knowledge and practice related to kidney disease detection, education, and treatment. Tools include the online glomerular filtration rate (GFR) calculators and the Nephrology Referral Form for use by primary care providers to share patient data with the consulting nephrologist. Reference materials include the Quick Reference on UACR/GFR fact sheet and CKD and Drug Dosing: Information for Providers. NKDEP also hosts webinars for health professionals on various topics such as "Improving Outcomes in Chronic Kidney Disease." NKDEP offers a suite of materials to help general practice registered dietitians (RDs) provide effective medical nutrition therapy to CKD patients who are not on dialysis. NKDEP is also collaborating with the American Dietetic Association to develop a certificate training program for RDs.

NKDEP and its Laboratory Working Group use a variety of channels to keep the clinical chemistry community informed about creatinine standardization and efforts to standardize measurement and reporting or urine albumin. Information is disseminated through the website, e-newsletters, and professional meetings.

NKDEP supports patient education by providing resources and tools that help health professionals better educate their patients about CKD. The Explaining Your Kidney Test Results: A Tear-off Pad for Clinical Use is intended for health professionals to use when explaining GFR and urine albumin test results with patients. The pad is available in English, Spanish, Chinese, and Vietnamese. In addition to the tear-off pad, NKDEP's Chronic Kidney Disease and Medicines: What You Need to Know brochure encourages CKD patients to turn to pharmacists for information and support. Lastly, NKDEP's website features videos that model for health professionals ways to answer common patient questions (in English and Spanish) on a wide series of topics related to CKD and kidney failure.

Contact Information
Andrew S. Narva, MD, FACP, FASN
Director, NKDEP
Phone: (301) 594-8864
Email: narvaa@niddk.nih.gov
Web: www.nkdep.nih.gov

Eileen Newman, MS, RD
Associate Director, NKDEP
Phone: (301) 435-8116
Email: eileen.newman@nih.gov
Web: www.nkdep.nih.gov

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Veterans Affairs (VA)

The VA is widely recognized as the largest provider of graduate medical education (GME) in the United States. The Undersecretary for Health of the Veterans Health Administration is a statutory member of the Council on Graduate Medical Education (COGME). Graduate medical education has traditionally been supported and centered in VA medical facilities associated with academic affiliates.

The VA also provides professional education through the development and dissemination of clinical practice guidelines. The VA in collaboration with the Department of Defense (DoD), created the first evidenced based clinical practice guideline pertaining to the management of chronic kidney disease within the primary care setting in the US. The VA/DoD chronic kidney disease (CKD) guideline, initially issued in 2001, was recently revised and reissued in 2008 to reflect current research.

VA has also been actively collaborating with NKDEP since 2009 in the development of healthcare provider education materials pertaining to CKD. The purpose of such efforts is to promote provider understanding of CKD and its treatment, and foster adoption and implementation of the VA/DoD CKD clinical practice guideline. These materials are available to VA specialty and primary care providers via the VA Renal Sharepoint and the Army Medical Department CPG shopping cart and website at https://www.qmo.amedd.army.mil.

The VA/DoD Clinical Practice Guideline for the Management of Chronic Kidney Disease also provides a concise summary of evidence-based recommendations on treatment of CKD and complications. The VA is collaborating with the DoD in developing a continuing education program pertaining to the CKD practice guideline for physicians, advanced practice nurses, physician assistants.

Contact Information
James Ellzy, CDR, US Navy
Director of Clinical Quality
Phone: 703-681-0064
Email: James.ellzy@amedd.army.mil
Web: www.tricare.mil

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This information was reviewed by KICC agency representatives. It may not reflect new or future agency activities. For more information, please contact the listed representatives.

Page last updated: June 6, 2012