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Although many investigators have pushed the envelope in researching how patients with chronic kidney disease (CKD) experience disabilities, there is still a need for more knowledge on how those disabilities evolve over time, according to Cynthia Delgado, MD, associate professor of medicine at the San Francisco Veterans Affairs Medical Center and University of California San Francisco Medical Center.

Physical disabilities may make it difficult for patients with chronic kidney disease to follow provider recommendations and achieve a good therapeutic alliance, which can lead to increased burden of illness, according to Cynthia Delgado, MD, associate professor of medicine at the San Francisco Veterans Affairs Medical Center and University of California San Francisco Medical Center.

Pathways are not trying to restrict or take control of treating the patient from the physician, it’s actually trying to enhance that for the physician and take the guesswork of how to do that out of it, said Rani Khetarpal, MBA, vice president of Oncology Value-Based Partnerships at New Century Health.

An increasing emphasis on prevention is shifting the mindset around pediatric nephrology, and findings from ongoing studies will further expand the evidence base, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Better blood pressure measurement techniques, electronic health record alerts, and simpler clinical practice guidelines can all help primary care clinicians identify hypertension in children, said Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Including an exercise physiologist or physical therapist on a multidisciplinary nephrology care team can make it easier to include exercise as part of routine care for chronic kidney disease (CKD), said Danielle Kirkman, PhD, assistant professor at Virginia Commonwealth University.

Implementing screening for chronic kidney disease (CKD) in the primary care setting can help identify patients who may benefit from upstream interventions and medications to reduce their risk of kidney failure, said Joseph Vassalotti, MD, clinical professor at Icahn School of Medicine at Mount Sinai and chief medical officer of the National Kidney Foundation.

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