Rushing into intense exercise after a break can cause “rhabdo”, potentially leading to kidney injury
To evaluate such tools, a team led by co–first authors Mallika Mendu, MD, MBA (Brigham and Women's Hospital) and Sri Lekha Tummalapalli, MD, MBA (University of California, San Francisco) and senior author Daniel Weiner, MD, MS (Tufts Medical Center) compiled a comprehensive list of quality metrics related to kidney disease from multiple organizations, including the Renal Physicians Association, the National Quality Forum, the National Committee for Quality Assurance, and the Centers for Medicare and Medicaid Services.
The study included 60 quality metrics, including 7 for CKD prevention, 2 for slowing CKD progression, 2 for CKD management, 1 for advanced CKD and kidney replacement planning, 28 for dialysis management, 18 for broad measures, and 2 patient-reported outcome measures. The investigators determined that less than half of the quality metrics were highly valid, and the others fell short because of unclear attribution, inadequate definitions, or discordance with recent evidence. Specifically, 49% of the metrics had high validity, 38% had medium validity, and 13% had low validity.
Also, nearly half of the metrics were related to dialysis management. The researchers advocate for refining existing measures and developing new metrics that better reflect the spectrum of kidney care delivery, and they present a framework as to how to achieve better measures.
This is an important time given the national attention to kidney care delivery and efforts of the current administration to improve kidney care. As such, it is important to make sure that we are measuring high quality kidney disease care accurately and appropriately. Our paper provides an evaluation of existing kidney quality measures to guide providers and policy makers regarding which measures are meaningful and should be utilized to measure quality. We also outline an approach to quality measure development and refinement for kidney disease." Dr.Mallika Mendu, Brigham and Women's Hospital Source:
American Society of Nephrology (ASN) Journal reference:
Mendu, M.L., et al. (2020) Measuring Quality in Kidney Care: An Evaluation of Existing Quality Metrics and Approach to Facilitating Improvements in Care Delivery. JASN. doi.org/10.1681/ASN.2019090869 .
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