Baxter Healthcare Corporation announced the launch of the chronic kidney disease (CKD) research program at the 2003 American Society of Nephrology (ASN) annual meeting in San Diego. In partnership with leading North American academic institutions and nephrology practices, including Harvard University (Cambridge, Mass.), Hospital of St. Raphael (New Haven, Conn.), Royal Victoria Hospital/McGill University Centre (Montreal, Quebec), Mid-Atlantic Nephrology Associates (Baltimore, Md.), Nephrology Associates (Birmingham, Ala.), Humber River Regional Hospital (Toronto, Canada) and Queen Elizabeth II Health Sciences Center (Halifax, Nova Scotia), Baxter believes the first-of-its-kind research collected from the program will help create a new model of renal care designed to encourage earlier kidney disease detection and treatment and, ultimately, greater survival for patients.
The complexity of chronic kidney disease (CKD), including comorbidities such as diabetes and hypertension, has made it difficult to manage CKD patients. This program aims, for the first time, to prescribe a meaningful and integrated model of CKD care to provide more timely initiation of medical intervention and treatment. Specifically, the program will examine the long-term clinical needs of chronic kidney disease (CKD) patients who have not yet progressed to dialysis treatment. Established research suggests that CKD patients who visit a nephrologist during the less-advanced stage of the disease are more apt to: comply with treatment; practice better self-care; better manage comorbidities (including diabetes and high-blood pressure); and ultimately extend their survival while on dialysis therapy.
"The CKD program will be the first concerted and long-term effort to study chronic kidney disease patients as their disease progresses. By documenting the current delivery of care we hope to influence both diagnosis and treatment practices to potentially delay the need for dialysis and, most importantly, offer the opportunity for greater survival," said Salim Mujais, M.D., vice president of Global Medical Affairs for Baxter's renal business.
A significant advantage of the program is the use of paper-less, computerized technology for gathering patient information to evaluate, categorize, track and report patient information in real-time. This will allow program participants and other healthcare providers, for the first time ever in CKD care, to provide immediate feedback to a multidisciplinary team and to act on information to provide more responsive and efficient patient care.
According to the National Kidney Foundation of America and the Kidney Foundation of Canada, more than 500,000 Americans and Canadians are being treated for kidney disease. Additionally, the incidence of end-stage renal disease (ESRD), requiring some form of renal dialysis or transplantation, is growing globally at a rate of five-to-six per cent annually. Diabetes is the leading cause of kidney failure in both countries. In the US, 17 million people have diabetes, while in Canada two million people have diabetes and another 2.5 million are at risk of developing the disease.
Traditionally, a nephrologist sees kidney disease patients when the disease has reached an advanced stage ultimately requiring dialysis. Late treatment referrals offer less opportunity to choose the most optimal treatment for a patient. They also can result in earlier patient deaths.
"Given the growing incidence of diabetes, high-blood pressure and obesity in North America, kidney disease and, ultimately, kidney failure present a great public health challenge," said Fred Finkelstein, MD, clinical professor of medicine at Yale University and chief of nephrology at the Hospital of St.Raphael, New Haven, Conn., and CKD program participant. "Better understanding the needs of kidney disease patients before the disease progresses and dialysis is required, can potentially improve treatment outcomes and lead to greater survival."
"The CKD program is the most unique approach to understanding the needs of CKD patients that I have seen during my 18 years in nephrology. The use of a computerized system where patient information can be quickly gathered and analyzed by multiple members of the CKD care team -- beyond the nephrologist -- to make immediate treatment decisions is a first in CKD care. The program can lead to ground-breaking changes in the way these patients are currently diagnosed and managed, and that can change lives dramatically for the better," said David Mendelssohn, M.D., associate professor of medicine at the University of Toronto and Head of the Division of Nephrology at Humber River Regional Hospital, Toronto, Canada, also a CKD program participant.
How the Chronic Kidney Disease (CKD) Program Works: Utilizing Same-Time Technology for Better Patient Care
Educational and clinical research results from the program are expected to be released within the next two years. The CKD program's objectives are unique among efforts to understand this patient group. It is designed to promote advanced CKD education to patients, better engaging and empowering them to take an active role in their own care. The program will examine these patients over the long-term course of their disease. Additionally, the program will prescribe a multi-disciplinary approach to CKD care, with tailored care pathways to address renal disease progression, anemia, hypertension, nutrition and preventive care, among other elements -- all contributing factors to the progression or regression of CKD.
A multi-disciplinary team will work together to quickly recognize, capture and share patient information gathered by the use of computerized, same-time technology to initiate timelier decision-making and patient care. For example, information on a patient's diabetes status and nutrition are entered into the CKD program software system and shared with an integrated team of health-care professionals, including a nephrologist, nutritionist, nurse, and a social worker, so that all members of a patient's CKD care team have access to the information and the opportunity to add analysis and recommendations based on their specialties. Program participants believe this unique level of organization and quick reaction can potentially improve patient care and survival.
The program will include several special research projects to better understand current issues of particular importance in nephrology including: CKD treatment practices and modality selection, examination of common comorbidities (diabetes, high-blood pressure and cardiovascular concerns) and their impact on CKD care, the progression of CKD, and the potential health economics benefit in earlier diagnosis and treatment of CKD. The data collection tool used in the CKD program will be incorporated into Baxter's RenalSoft software suite. Additional analysis of the data can be achieved with the software program.