KidneyWise Clinical Toolkit update: What you need to know

Early identification and treatment of chronic kidney disease (CKD) is important. It helps to prevent progression to more advanced stages that require renal replacement therapy, such as dialysis or transplant.

It also reduces the risk of developing cardiovascular co-morbid conditions such as stroke, coronary artery disease and peripheral vascular disease.

For both of these reasons, the Ontario Renal Network created the KidneyWise Clinical Toolkit in 2015.

This evidence-based resource helps guide primary care providers (e.g. family physicians, nurse practitioners) in identifying, detecting and managing CKD in their practices. The toolkit also provides information on which patients may benefit from a referral to nephrology.

KidneyWise was recently updated and relaunched. The new interactive website, available at kidneywise.ca, includes updated evidence and a new design.

These changes contribute to a collaborative person-centred care model that empowers providers to improve patient outcomes in CKD.

What has changed?

The updates reflect new evidence and user experience over the past three years. New features and information include:

• addition of people 18 years of age and older from First Nations, Inuit and Métis groups in the Identify & Evaluate section of the Clinical Algorithm
• changes to blood pressure treatment targets for people with CKD and hypertension in the Manage section of the Clinical Algorithm
• changes to the indications for nephrology referral, which now includes a five-year ≥ 5% probability of progression to end-stage renal disease using the Kidney Failure Risk Equation (KFRE)
• an updated Evidence Summary

The new website replaces the decommissioned mobile app. It allows users to access the toolkit in real time.

How does KidneyWise help primary care providers?

It offers guidance to help users:

• recognize which patients in a typical family practice are at highest risk for CKD and are most appropriate for screening
• determine which tests to order to diagnose CKD and how to interpret the results
• better care for people with CKD, to prevent further disease progression and reduce the risk of developing cardiovascular diseases

KidneyWise provides recommendations for referral to nephrology, along with the appropriate investigations that should accompany the referral.

The toolkit can be integrated into a provider’s electronic medical record (EMR). The Ontario Renal Network continues to make collaboration efforts to support EMR integration.

How does KidneyWise benefit the patient experience?

Person-centred chronic disease management has been a goal of both the original resource and the current update.

By having access, primary care providers can be confident using the latest evidence at point of care that is consistent across Ontario.

As well, through collaboration with nephrologists, patients requiring referral can be seen in a timely fashion.

To learn more about KidneyWise and to access the tool, visit kidneywise.ca

Question about this blog post? Email us at publicaffairs@cancercare.on.ca