Kidney Disease Evaluation for Patients with Diabetes (KED) | January 2022 | Clinical Corner

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January 1, 2022

Kidney Disease EVALUATION for Patients with Diabetes (KED)

 

HEDIS MEASURE:

The percentage of adults ages 18 to 85 years of age with diabetes, as of December 31 of measurement year, who received a kidney health evaluation.

BACKGROUND:

  1. Factsa
    • Approximately 90% of those with early kidney disease don't know they have it.
    • Approximately 1 in 3 adults with diabetes may have kidney disease or are at risk.
    • Kidney disease affects an estimated 37 million people in the U.S. (15% of the adult population; more than 1 in 7 adults).
    • African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage renal disease (kidney failure).
  2. The Test
    • Kidney Health Evaluation includes both an estimated glomerular filtration rate (eGFR) and a urine albumin-creatinine ratio (uACR).
    • At least one eGFR is required during the measurement period.
    • At least one uACR is required during the measurement period.
      • The uACR is identified by the member having both a quantitative urine albumin test and a urine creatinine test with service dates four or less days apart.
    • the eGFR assesses kidney function while the uACR assesses kidney damage.
    • Results of the KED provide physicians and patients with the critical information they need to identify chronic kidney disease (CKD) and develop a treatment plan which may include additional testing, lifestyle changes, medicine, treating the risk factors for diabetes or a referral to a nephrologist for further evaluation.
    • But once kidneys fail, treatment with dialysis or a kidney transplant is needed.
  3. Exclusions from Testing
    • Evidence of ESRD or dialysis any time during the member’s history.
    • Members receiving palliative care or in hospice during the measurement year.
    • Members 66 years of age and older as of December 31 of the measurement year with frailty and advanced illness (see advanced illness guide).
    • Members 81 years of age or older as of December 31 of the measurement year with frailty.
    • Members that did not have a diagnosis of diabetes and who had a diagnosis of polycystic ovarian syndrome, gestational diabetes or steroid-induced diabetes during the measurement year or the year prior to the measurement year in any setting.

    References:

    1. https://www.kidney.org/news/newsroom/fsindex#fast-facts