Improving Quality
and Financial Results

primaris flame Chronic Kidney Disease

Chronic Kidney Disease (CKD), the slow, progressive loss of kidney function, is the 9th leading cause of death for Missourians. Diabetes and Hypertension are the two main culprits behind CKD.

Missouri physicians are in a select group – Physicians in only 10 states have been given the opportunity to receive free assistance from their state’s Medicare Quality Improvement Organization (QIO) to address the urgent need to slow the progression of CKD.

Consider partnering with Primaris, Missouri’s QIO, to detect the incidence and slow the progression of CKD in Missouri’s Medicare population.

Project focus:

  • Timely testing to detect the rate of kidney failure due to diabetes. 
  • Slow the progression of kidney disease in people diagnosed with diabetes and hypertension. 
  • AV fistula placement and maturation (as a first choice for arteriovenous access where medically appropriate) for individuals who elect, as part of timely renal placement therapy counseling, hemodialysis as their treatment option for kidney failure.

Kidney damage is irreversible, but treatment can help delay or prevent kidney failure. Work with Primaris to implement system change that will improve the quality of CKD monitoring and care. Enhanced quality of life, reductions in death rates and health cost savings can result from preserving kidney health.

If you are interested in learning how we can provide you with free assistance through the Missouri CKD project, contact Kristen Bird at 800-735-6776 x 117 or kbird@primaris.org.

Primaris has several free resources available on this topic.

Patient Education Provider Education Provider Tools Presentations Links

Patient Education


Diabetes: Know and Follow Your SIgnals

Publication #: MO-10-22-CKD

This helpful poster shows patients what signals they and their healthcare providers can monitor for improved kidney health.


Diabetes Personal Record Wallet Card

Publication #: MO-09-10-CKD

A wallet-sized form to track important tests and screenings to manage diabetes care. Patients bring this on every visit to the doctor. Prints on 8.5 by 11 paper, then cut into thirds.


Diabetes & High Blood Pressure: Making the Kidney Connection

For people with diabetes or high blood pressure. Explains the key risk factors for kidney disease and the importance of getting tested. Produced by the National Kidney Disease Education Program.


Diabetes & High Blood Pressure Brochure for African Americans

For African Americans with diabetes or high blood pressure. Explains the key risk factors for kidney disease and the importance of getting tested. Produced by the National Kidney Disease Education Program.


"You Have The Power To Prevent Kidney Disease" Video (VHS)

This VHS video features an African-American woman living with kidney failure and details her son's decision to get tested for kidney disease. It emphasizes the risk factors for kidney disease and steps that can be taken to prevent or delay kidney failure. It encourages people at risk for kidney disease to get tested.

The video was produced by the National Kidney Disease Education Program and viewable online on their web site. (4 minutes)


Urine Micro-Albumin Handout

Publication #: MO-09-34-CKD

This handout illustrates the importance of getting a simple urine test to determine a patient's risk for chronic-kidney disease if they meet certain criteria. The first file, "Bob", uses a Caucasian model, while the second, "Bill", features African-American models.


How well are your kidneys working?

Explains the key risk factors for kidney disease and the importance of getting tested. Produced by the National Kidney Disease Education Program.


How well are your kidneys working? - ¿Qué tan bien están funcionando sus riñones?

Spanish language version. Explains the key risk factors for kidney disease and the importance of getting tested. Produced by the National Kidney Disease Education Program.


eGFR and CKD Patient Brochure

This Patient Education brochure was developed by the Missouri Department of Health and Senior Services and provides explanations of eGFR and how it relates to kidney disease.


Understanding GFR

This small handout explains what a glomerular filtration rate (GFR) is and how monitoring it can help patients better understand their own kidney health. It was produced by the National Kidney Disease Education Program.


"If You Have Diabetes, Keep the Pressure Down" flyer

Publication #: MO-09-47-CKD

This flyer promotes early detection and treatment for people suffering from both diabetes and high blood pressure.


High Blood Pressure and Chronic Kidney Disease Booklet

The booklet provides consumer education on high blood pressure and how it is linked to kidney disease. Developed by the National Kidney Foundation.

Editor's note: This tool can be directly downloaded from the National Kidney Foundation Web site.


Diabetes and Chronic Kidney Disease Booklet

The booklet provides consumer education on diabetes and how it is linked to kidney disease. Developed by the National Kidney Foundation.

This file is available on the National Kidney Foundation Web site.


Family Reunion Health Guide Booklet

Encourages families to discuss kidney disease at family reunions and other gatherings. Provides three sample approaches and fact sheets on diabetes, high blood pressure, and kidney disease. Designed for family reunion planners or family health champions. Only one copy needed per family. Produced by the National Kidney Disease Education Program.


The Facts About Vascular Access

Publication #: MO-10-03-CKD

This folded booklet discusses the different types of vascular access available to patients who must undergo hemodialysis.


Missouri Kidney Program: Patient Education Program Brochure

This brochure provides information about The Missouri Kidney Program's educational series for patients, their families and friends. Classes are offered around the state. This program is designed to help patients learn more about kidney disease, options for treatment, and how to live well with kidney disease.


Fistula First: Frequently Asked Questions brochure

This tri-fold brochure answers common questions for patients and families. Produced through the AV Fistula First Breakthrough Initiative Coalition


Kidney Disease Resources

Publication #: MO-09-22-CKD

A quick guide to websites with some useful CKD resources.


Provider Education

CKD Algorithm for Assessment

Publication #: MO-09-25 CKD

Guide to identification, treatment and referral for CKD.

Chronic Kidney Disease Informational Tool

Publication #: MO-09-26 CKD

Informational guide to CKD including a GFR, actions and ICD-9 codes for all stages; risk factors; kidney damage indicators; management and damage delay strategies; patient education tips and more.

Urine to Creatinine Ratio/Estimated Glomerular Filtration Rate Tool

The two key markers for kidney disease are urine albumin and estimated glomerular filtration rate (eGFR). Use this quick reference from the National Kidney Disease Education Program to help interpret UACR and eGFR test results.

Blood Pressure Medication Fact Sheet

Publication #: MO-10-32-CKD

Highlighting the benefits of taking blood pressure medication, this fact sheet helps people with high blood pressure understand how this medication helps prevent strokes, heart attacks, and kidney problems.

Dosing of ACE-Inhibitors and ARBs

Dosing chart for a variety of ACE-Inhibitors and ARBs.

Managing Adverse Effects of ACE-I/ARB Therapy

Hypotension, early decrease in GFR, and hyperkalemia are all dose-related adverse effects related to the reduced Angiotensin II levels, through the inhibition of ACE or blockade of the Angiotensin II (AT1) receptor. These adverse effects may be avoided by...

"30-20-10" - A Guide to Treatment of Later Stage CKD Patients

Publication #: MO-10-07-CKD

Knowing when to make a referral to a nephrologist is a common problem, however this quick reference card outlines Hakim and Himmelfarb's algorithm of “30-20-10” for referral and placement of permanent access. Print this card as a reminder to ensure timely referrals based off a patient’s GFR.

CKD Algorithms (Advanced)

Five algorithms that address clinical problems in the care of patients with advanced CKD:

  • Anemia
  • Hypertension
  • Bone Disease
  • Nutrition
  • Lipids

All are based on an RPA Clinical Practice Guideline #3, Oct. 2002.

CKD Crisis Update No. 1

In this June 2009 issue of CKD Crisis Update, authors discuss the main initiatives of the Chronic Kidney Disease program.


Provider Tools

Diabetes Care Flowsheet & Algorithm

Publication #: MO-09-13-CKD

Primary Care Coding Guide for Chronic Kidney Disease

Publication #: MO-10-08-CKD

This coding sheet serves as a guide to correctly recording CKD-related diagnoses.

Primary Care Physician Fax Form

Publication #: MO-10-09-CKD

This customizable fax form can be used by primary care physicians to request a nephrologist consult regarding a specific patient.

Diabetes Individual Care Plan

Publication #: MO-09-12-CKD

A one-page document to outline important test results, including room for physician recommendations and patient goals.

Diabetes Check-Up Handout

Publication #: MO-09-06-CKD

Use this handout to reinforce the importance of close medical management and regular testing for diabetes.

Save the Vein Tool Kit

Publication #: MO-09-47-CKD

People with chronic kidney disease (CKD) or a disease like diabetes, hypertension, lupus, or polycystic kidney disease that can damage the kidneys could develop kidney failure requiring dialysis. It is important for at-risk patients to understand the importance of preserving their veins in the case they would require future hemodialysis access. We have free resources to promote this important message to your patients.

These resources include an arm band (to show providers which arm should be preserved, and not subjected to injections, etc.), a wallet card and arm band card. Order yours today!


Presentations

Decrease the Increase in Chronic Kidney Disease Presentation 2009

A recording from the Decrease the Increase in Chronic Kidney Disease WebEx session held Oct. 28, 2009. This file requires a WebEx player.

Diabetes & CKD: What's the Connection? PowerPoint Presentation

Publication #: MO-09-11-CKD

This presentation covers:

  • Number of people in U.S. with diabetes
  • Diabetes and related problems
  • Diabetes and Chronic Kidney Disease (CKD)
  • Stages of CKD
  • What you can do to help yourself

(35 slides)

Kidneys and Kidney Disease: Presentation for Home Health Aides

Publication #: MO-08-06-CKD

Objectives include:

  • Gain an understanding of kidney functions
  • Learn possible causes of kidney disease
  • Learn types of kidney disease
  • Learn symptoms of kidney disease
  • Understand emotional aspects of kidney disease
  • Learn type and care of dialysis access
  • Urinary catheter care

Kidney-related Web sites