Performance on Chronic Kidney Disease Clinical Quality Measures over the 24-Month Intervention
| CKD Clinical Quality Measure | Baseline | 24 Months | Change from Baseline to Month 24 (%M24−BL) | ||
|---|---|---|---|---|---|
| %BL | NBL | %M24 | NM24 | ||
| Identification of patients with CKD | |||||
| eGFR in the past year for patients with DM and/or hypertension | 87 (80, 93) | 929 (590, 1303) | 87.5 (82, 92) | 795 (608, 1256) | 0.5 (−2.0, 5.0) |
| Screening for albuminuria in the past year for patients with DM and/or hypertension | 21.5 (16, 26) | 929.5 (590, 1303) | 59 (37, 73) | 795 (608, 1256) | 30.0 (23.0, 46.0)* |
| Monitoring patients with CKD | |||||
| eGFR in the past 6 months for patients with stage 3 CKD | 76 (72, 86) | 169.5 (122, 279) | 80.5 (76, 83) | 205.5 (149, 263) | 0.5 (−3.0, 3.0) |
| eGFR in the past 3 months for patients with stage 4 CKD | 75 (63, 80) | 10.5 (5, 16) | 74 (63, 80) | 11.5 (7, 15) | −3.0 (−7.0, 0.0) |
| Monitoring albuminuria in past year for patients with CKD (without prior macroalbuminuria or proteinuria) | 34.5 (27, 55) | 190.5 (131, 356) | 63 (53, 83) | 325 (201, 420) | 25.0 (22.0, 31.0)* |
| BP management in patients with CKD | |||||
| Most recent BP <140/90 mmHg for patients with CKD without macroalbuminuria or proteinuria | 76 (68, 83) | 191.5 (131, 357) | 76.5 (73, 82) | 325.5 (201, 422) | 2.5 (0.0, 7.0) |
| Most recent BP <130/80 mmHg for patients with CKD with macroalbuminuria or proteinuria | 33 (30, 57) | 2.5 (1, 7) | 29 (13, 33) | 8.5 (3, 15) | −1.5 (−50.5, 9.0) |
| ACEI or ARB in the past year for patients with CKD and hypertension with macroalbuminuria or proteinuria | 53.5 (43, 67) | 2.5 (1, 7) | 65.5 (52, 100) | 8.5 (3, 15) | 23.5 (−5.5, 43.5) |
| Dyslipidemia in patients with CKD | |||||
| Lipid panel in the past year for patients with CKD | 84.5 (82, 87) | 202.5 (131, 367) | 84 (82, 88) | 340.5 (209, 441) | −0.5 (−4.0, 1.0) |
| Anemia in patients with CKD | |||||
| Hemoglobin in the past year for patients with eGFR <45 | 77 (74, 82) | 60 (34, 110) | 86 (70, 91) | 69.5 (39, 91) | 7.0 (0.0, 8.0) |
| Avoidance of potential nephrotoxic drugs | |||||
| Avoidance of NSAIDs or COX-2 inhibitors in patients with CKD | 94 (91, 96) | 202.5 (131, 367) | 92 (92, 94) | 340.5 (209, 441) | −1.0 (−2.0, 1.0) |
Data are median (25th percentile, 75th percentile).
↵* P < .0005.
%BL, Proportion of testing at baseline; %M24, proportion of testing at month 24; %M24−BL, absolute change in proportion; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CKD, chronic kidney disease; COX-2, cyclooxygenase 2; eGFR, estimated glomerular filtration rate; DM, diabetes mellitus; BP, blood pressure; NBL, number of patients eligible for testing at baseline; NM24, number of patients eligible for testing at month 24; NSAID, nonsteroidal anti-inflammatory drug.