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  1. Article: A model for improving CKD outcomes.

    Narva, Andrew S

    JAAPA : official journal of the American Academy of Physician Assistants

    2016  Volume 29, Issue 11, Page(s) 14

    Language English
    Publishing date 2016-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2415226-2
    ISSN 0893-7400 ; 1547-1896
    ISSN (online) 0893-7400
    ISSN 1547-1896
    DOI 10.1097/01.JAA.0000502869.51469.bf
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6624: Show issues Location:
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  2. Article ; Online: Could a Pragmatic Detection Strategy Be the Gateway for Effective Population Health for CKD?

    Narva, Andrew S / Norton, Jenna M

    Journal of the American Society of Nephrology : JASN

    2019  Volume 31, Issue 9, Page(s) 1921–1922

    MeSH term(s) Developed Countries ; Early Diagnosis ; Humans ; Income ; Population Health ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology
    Keywords covid19
    Language English
    Publishing date 2019-01-19
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2020070992
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3344: Show issues Location:
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  4. Article ; Online: Overcoming barriers to implementing new guideline-directed therapies for chronic kidney disease.

    Nee, Robert / Yuan, Christina M / Narva, Andrew S / Yan, Guofen / Norris, Keith C

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2022  Volume 38, Issue 3, Page(s) 532–541

    Abstract: For the first time in many years, guideline-directed drug therapies have emerged that offer substantial cardiorenal benefits, improved quality of life and longevity in patients with chronic kidney disease (CKD) and type 2 diabetes. These treatment ... ...

    Abstract For the first time in many years, guideline-directed drug therapies have emerged that offer substantial cardiorenal benefits, improved quality of life and longevity in patients with chronic kidney disease (CKD) and type 2 diabetes. These treatment options include sodium-glucose cotransporter-2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists and glucagon-like peptide-1 receptor agonists. However, despite compelling evidence from multiple clinical trials, their uptake has been slow in routine clinical practice, reminiscent of the historical evolution of angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker use. The delay in implementation of these evidence-based therapies highlights the many challenges to optimal CKD care, including: (i) clinical inertia; (ii) low CKD awareness; (iii) suboptimal kidney disease education among patients and providers; (iv) lack of patient and community engagement; (v) multimorbidity and polypharmacy; (vi) challenges in the primary care setting; (vii) fragmented CKD care; (viii) disparities in underserved populations; (ix) lack of public policy focused on health equity; and (x) high drug prices. These barriers to optimal cardiorenal outcomes can be ameliorated by a multifaceted approach, using the Chronic Care Model framework, to include patient and provider education, patient self-management programs, shared decision making, electronic clinical decision support tools, quality improvement initiatives, clear practice guidelines, multidisciplinary and collaborative care, provider accountability, and robust health information technology. It is incumbent on the global kidney community to take on a multidimensional perspective of CKD care by addressing patient-, community-, provider-, healthcare system- and policy-level barriers.
    MeSH term(s) Humans ; Diabetes Mellitus, Type 2/drug therapy ; Quality of Life ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Renal Insufficiency, Chronic/therapy ; Kidney
    Chemical Substances Sodium-Glucose Transporter 2 Inhibitors
    Language English
    Publishing date 2022-10-19
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfac283
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    Zs.MO 329: Show issues

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  5. Article ; Online: Decision support and CKD: not there yet.

    Narva, Andrew S

    Clinical journal of the American Society of Nephrology : CJASN

    2012  Volume 7, Issue 4, Page(s) 525–526

    MeSH term(s) Decision Support Systems, Clinical ; Diabetic Nephropathies/diagnosis ; Glomerular Filtration Rate ; Humans ; Kidney/physiopathology ; Kidney Diseases/diagnosis ; Proteinuria/diagnosis ; Reminder Systems
    Language English
    Publishing date 2012-04
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.02140212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6584: Show issues Location:
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  6. Article: Standardization of Urine Albumin Measurements: Status and Performance Goals.

    Miller, W Greg / Seegmiller, Jesse C / Lieske, John C / Narva, Andrew S / Bachmann, Lorin M

    The journal of applied laboratory medicine

    2021  Volume 2, Issue 3, Page(s) 423–429

    Abstract: Background: Urine albumin is a key laboratory test used for classification, assessment of risk, and monitoring treatment of patients with chronic kidney disease. Urine albumin measurement results are not standardized among different measurement ... ...

    Abstract Background: Urine albumin is a key laboratory test used for classification, assessment of risk, and monitoring treatment of patients with chronic kidney disease. Urine albumin measurement results are not standardized among different measurement procedures. Consequently, clinical guidelines using fixed decision values for urine albumin cannot be applied consistently.
    Content: Isotope dilution mass spectrometry reference measurement procedures and certified reference materials are being developed to enable standardization of immunoassay measurement procedures for urine albumin. A previous report determined calibration bias was the major error source for differences in results among different measurement procedures for urine albumin. Performance goals for between-day precision, ≤6% CV above 15 mg/L, and for specimen-specific effects, ≤6% CV, were established on the basis of the performance capability of current measurement procedures. The biological variation model was used to estimate a total allowable error of ≤24%-30% and from that the goal for bias of ≤7%-13%.
    Summary: A reference system of higher-order certified reference materials and reference measurement procedures is being developed to enable standardization of urine albumin measurement results. Goals have been established for total allowable error, specimen-specific effects, imprecision, and bias to facilitate efforts to standardize urine albumin measurement results.
    Language English
    Publishing date 2021-01-26
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1373/jalm.2017.023614
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  7. Article ; Online: Assessment of kidney function for drug dosing.

    Narva, Andrew S

    Clinical chemistry

    2009  Volume 55, Issue 9, Page(s) 1609–1611

    MeSH term(s) Drug Dosage Calculations ; Humans ; Kidney/drug effects ; Kidney/physiology ; Kidney Diseases/chemically induced ; Pharmaceutical Preparations/chemistry ; Pharmacology
    Chemical Substances Pharmaceutical Preparations
    Language English
    Publishing date 2009-07-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 80102-1
    ISSN 1530-8561 ; 0009-9147
    ISSN (online) 1530-8561
    ISSN 0009-9147
    DOI 10.1373/clinchem.2009.127944
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    Ud II Zs.171: Show issues Location:
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  8. Article ; Online: Optimal preparation for ESRD.

    Narva, Andrew S

    Clinical journal of the American Society of Nephrology : CJASN

    2009  Volume 4 Suppl 1, Page(s) S110–3

    Abstract: Clinical guidelines for the care of patients with progressive chronic kidney disease (CKD) have been developed by a broad range of organizations within the kidney community. Despite consensus among these guidelines and significant effort on the part of ... ...

    Abstract Clinical guidelines for the care of patients with progressive chronic kidney disease (CKD) have been developed by a broad range of organizations within the kidney community. Despite consensus among these guidelines and significant effort on the part of federal agencies, voluntary health organizations, and professional groups, existing data suggest that much work remains to achieve acceptable levels of recommended care. Several small studies have described CKD interventions to improve outcomes, but there are few examples of large-scale attempts to improve CKD care in a systematic way. Southern California Kaiser Permanente has developed a population management approach to CKD in a health maintenance organization setting that has improved outcomes. The Indian Health Service, an agency of the Public Health Service that provides direct care to American Indians and Alaska Natives, has enhanced its diabetes care delivery system to address the renal complications of diabetes. This effort may explain a significant decrease in the incidence rate of ESRD among American Indians with diabetes. Because much of the burden of CKD falls on ethnic and racial groups with decreased access to care, enhancing CKD care in the primary setting may offer the best opportunity to improve outcomes. The National Kidney Disease Education Program in collaboration with community heath centers has developed a model to improve outcomes through application of the chronic care model to CKD management in primary settings that serve high-risk populations.
    MeSH term(s) Combined Modality Therapy ; Community Health Centers/organization & administration ; Disease Progression ; Guideline Adherence ; Health Education/organization & administration ; Health Maintenance Organizations/organization & administration ; Health Services Accessibility/organization & administration ; Healthcare Disparities ; Humans ; Kidney Failure, Chronic/ethnology ; Kidney Failure, Chronic/therapy ; Organizational Objectives ; Practice Guidelines as Topic ; Primary Health Care/organization & administration ; Quality of Health Care/organization & administration ; Treatment Outcome ; United States/epidemiology ; United States Indian Health Service/organization & administration
    Language English
    Publishing date 2009-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2226665-3
    ISSN 1555-905X ; 1555-9041
    ISSN (online) 1555-905X
    ISSN 1555-9041
    DOI 10.2215/CJN.03900609
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6584: Show issues Location:
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  9. Article: Laboratory Assessment of Diabetic Kidney Disease.

    Narva, Andrew S / Bilous, Rudolf W

    Diabetes spectrum : a publication of the American Diabetes Association

    2014  Volume 28, Issue 3, Page(s) 162–166

    Abstract: IN BRIEF Regardless of etiology, chronic kidney disease (CKD) is identified by two laboratory tests: 1) estimated glomerular filtration rate (eGFR), a measure of kidney function, and 2) urine albumin-to-creatinine ratio (UACR), a measure of kidney damage. ...

    Abstract IN BRIEF Regardless of etiology, chronic kidney disease (CKD) is identified by two laboratory tests: 1) estimated glomerular filtration rate (eGFR), a measure of kidney function, and 2) urine albumin-to-creatinine ratio (UACR), a measure of kidney damage. It is crucial for all health professionals to understand the significance and limitations of these tests to appropriately identify CKD patients, guide therapy, and determine prognosis. This article provides information that will enable diabetes educators and other clinicians to properly interpret eGFR and UACR laboratory results in the identification and management of CKD.
    Language English
    Publishing date 2014-05-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2211544-4
    ISSN 1040-9165
    ISSN 1040-9165
    DOI 10.2337/diaspect.28.3.162
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    Zs.A 6232: Show issues Location:
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  10. Article: The National Kidney Disease Education Program and other related efforts in the United States.

    Narva, Andrew S

    Scandinavian journal of clinical and laboratory investigation. Supplementum

    2008  Volume 241, Page(s) 12–15

    Abstract: The National Kidney Disease Education Program (NKDEP) works to reduce the morbidity and mortality caused by chronic kidney disease (CKD) and its complications through educational efforts targeted towards at-risk communities, patients and health-care ... ...

    Abstract The National Kidney Disease Education Program (NKDEP) works to reduce the morbidity and mortality caused by chronic kidney disease (CKD) and its complications through educational efforts targeted towards at-risk communities, patients and health-care professionals. NKDEP aims to improve early detection of CKD, facilitate identification of patients at greatest risk for progression to kidney failure and promote evidence-based interventions. Barriers to achieving these goals include confusion and misunderstanding of the laboratory tests used to identify and monitor patients with CKD. Through the Laboratory Working Group, NKDEP has collaborated with the clinical chemistry community to standardize creatinine measurements, promote the routine reporting of eGFR and standardize the measurement and reporting of urine albumin. It is hoped that these efforts will improve screening, clinical care and research in CKD and facilitate the implementation of evidence-based care recommended by the National Kidney Foundation and others.
    MeSH term(s) Albuminuria/diagnosis ; Chronic Disease ; Creatinine/blood ; Glomerular Filtration Rate ; Health Education ; Humans ; Kidney Diseases/diagnosis ; Patient Education as Topic ; United States
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2008
    Publishing country Norway
    Document type Journal Article
    ZDB-ID 230958-0
    ISSN 0085-591X
    ISSN 0085-591X
    DOI 10.1080/00365510802144870
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    In stock of ZB MED Bonn / Germany

    83/20111: Show issues

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