'Choosing Wisely' Suggestions Should Improve Kidney Care
(HealthDay News) – The American Society of Nephrology (ASN) Quality and Patient Safety (QPS) Task Force has developed a set of five recommendations to improve care for patients with kidney disease, according to an article published online Sept. 13 in the Clinical Journal of the American Society of Nephrology.
Amy W Williams, MD, from the Mayo Clinic in Rochester, MN, and colleagues on behalf of the ASN QPS Task Force initiated the "Choosing Wisely" campaign to identify areas in patient care and resource use that could be improved. Each of nine subspecialty organizations identified five tests, procedures, or therapies that they believe to be overused, misused, or could potentially lead to harm or unnecessary health care spending.
The Task Force selected the following five recommendations based on their relevance and importance to patients with kidney disease. Routine cancer screening should not be performed for dialysis patients with limited life expectancies who are without signs or symptoms. Erythropoiesis-stimulating agents should not be administered to patients with chronic kidney disease (CKD) with hemoglobin levels ≥10g/dL who do not have symptoms of anemia. Nonsteroidal anti-inflammatory drugs should be avoided for individuals with hypertension, heart failure, or CKD of all causes, including diabetes. Peripherally-inserted central catheters should not be placed in Stage 3–5 CKD patients without a nephrology consult. Finally, chronic dialysis should not be initiated without a shared decision-making process involving patients, their family, and their physicians.
"The five recommendations developed by the ASN QPS Task Force for the 'Choosing Wisely' campaign should help prompt and encourage conversations between patients and care teams and lead to a mutual understanding of the risks, benefits, and impact on the patient's overall outcome," the authors write.