Project training more Manitoba family doctors to calculate kidney failure risk
A pair of doctors , one a kidney specialist, the other a family physician, are teaming up to get more health care providers to use a math equation that can pretty accurately predict a person’s risk of kidney failure.
It’s called the Kidney Failure Risk Equation and it was developed several years ago by Dr. Navdeep Tangri, a kidney specialist at Seven Oaks Hospital.
“The equation uses readily collected data, so data that’s routinely available through regular blood tests or urine tests and helps patients and doctors understand whether they are low risk, high risk or somewhere in the middle,” Dr. Tangri said.
The equation uses a person’s age, gender, glomerular filrtation rate, and results from a particular urine test. For the most part, Dr. Tangri said it’s widely used by kidney specialists, who typically see patients who are already diagnosed with kidney disease and are at a more advanced stage.
“What we’ve learnt is that most patients with kidney disease don’t encounter a kidney doctor first, most of them encounter their family physician and most diagnoses’ of kidney disease are actually made by family physicians,” said Dr. Tangri.
That is why he and his research partner Dr. Alex Singer, who is a family physician, are testing to see if educating community clinics on the equation will help with early treatment.
“This kind of equation helps us target more specifically and be really focused in our approach and it helps us really manage the patients that need management the most and sort of figure that out in a way that is reproducible and can be done in various settings,” said Dr. Singer.
The ongoing research is expected to take one year. Thirty-two clinics are taking part, but only half will get educated on the equation, an audit on their current kidney failure treatment, and feedback on how to improve.
Dr. Singer said the aim is to make the equation the standard of care in treating kidney failure in the community. He also hopes that the same model of research can be used in treating other chronic diseases at the community level.
“We are not treating chronic diseases by hospitalizing people and operating on them,” he said. “We are treating them by keeping them healthy while they are still living in their community and at home.”
Dialysis can be avoided if caught early
Cathy Woods was diagnosed with kidney disease in late 2010. She said it was caught by her family doctor.
“It was a really scary time trying to get my head around the fact that I had kidney disease because it was a routine physical, I had no symptoms at the time,” Woods said.
Dr. Tangri said kidney disease affects 1 in 10 Canadians, adding early diagnosis can make a big difference in outcomes.
“If you have diabetes and kidney disease today there is a treatment out there that can delay dialysis by up to 2 decades and potentially prevent it all together, but all of that is non-applicable, we can’t start people on that treatment once their kidney function drops below 30-percent.”
Woods said she’s now in remission and routinely sees her family doctor and renal specialist to keep an eye on her kidney function.
“I’m always mindful at some point that it may come back,” she said.
She thinks the equation is a great tool for doctors and patients alike and encourages people to get involved in their kidney and general health.
“That’s the number one thing that people really need to understand, and they need to be involved in it,” she said. “It’s one of those diseases that nobody really thinks about, but a lot of people have it.”