DigiCon

What are the most common symptoms seen in the CKD patients? (Please choose more than one, wherever applicable) *

a) Weight loss and poor appetite Pedal edema

b) Fatigue Shortness of breath

c) Dry, itchy skin Changes in urination (Increase/decrease)

d) Headaches Nausea and vomiting

e) Blood in the urine Muscle cramps

f) Any Other

What are your perceived goals of management in a CKD patient? (Please choose more than one, wherever applicable) *

a) Slow the rate of disease progression to complete kidney failure

b) Preservation and optimization of renal function

c) Prevention/ treatment of complications and other medical conditions

d) Achieve/ maintain optimal nutritional status

e) Prevent Protein-Energy Wasting (PEW)

According to you which are the key primary aspects of effectively managing CKD and preventing its progression? (Please choose more than one, wherever applicable) *

a) Blockade of the renin angiotensin aldosterone (RAAS) system with either an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB)

b) Individualize BP targets and agents according to age, coexistent cardiovascular disease and other comorbidities

c) Optimally manage comorbid diabetes and address cardiovascular risk factors to decrease risk for cardiovascular disease

d) Monitor for other common complications of CKD including: anaemia, electrolyte abnormalities, abnormal fluid balance, mineral bone disease, and malnutrition

e) Avoid nephrotoxic medications to prevent worsening renal function.

f) Lifestyle modifications (dietary management weight management, smoking and physical activity)

Protein-Energy Wasting (PEW) is very common in CKD patients. The prevalence of PEW has been reported to be 20–25% in early to moderate CKD and increases as CKD progresses. To what extent do you encounter PEW in your patients? *

a) Yes

b) No

c) Yes, and the prevalence is between 5 – 10%

d) Yes, and the prevalence is between 10 – 20%

Do you favour using specific scales like Subjective Global Assessment (SGA) and Malnutrition Inflammation Score (MIS) to identify PEW? *

a) Yes

b) No

c) Any other scale

How do you prefer managing a patient with identified PEW? (Please choose more than one, wherever applicable) *

a) Oral nutritional supplements

b) Enteral feeding (In select cases)

c) Parenteral nutritional support

d) Growth hormon

e) Exercise in combination to nutrition

f) Appetite stimulants

g) Anabolic steroids/Anti-inflammatory interventions (e.g : Omega 3-fatty acids)

h) Refer to Specialist renal dietician

What is your opinion of using ‘Keto-analogues’ in CKD patients? *

a) Yes, I prescribe keto-analogues in my patients

b) Yes, I aware of keto-analogues, but have not yet prescribed in my patients

c) No, I am not sure about the use of keto-analogues in CKD patients

d) No, I am not convinced about the benefits of keto-analogues in CKD patients No experience as yet

In case you are prescribing keto-analogues in your patients, kindly share the reasons for the same. (Based on your response to Q6) (Please choose more than one, wherever applicable) *

a) It represents an additional therapeutic strategy to slow the progression of CKD.

b) It substantially reduces the risk of initiating long-term dialysis

c) It decreases mortality risk in patients with anaemic advanced chronic kidney disease

d) It is safe, well tolerated and improves the nutritional status

In case you are NOT prescribing keto-analogues in your patients, kindly share the reasons for the same. (Based on your response to Q6) (Please choose more than one, wherever applicable) *

a) Lack of clinical evidence for the benefits in supplementing keto-analogues in CKD patients

b) Keto-analogue supplementation has no significant effect in preserving the renal function

c) It increases the pill-burden in my patients

d) It is not cost-effective

Can you share your experience while prescribing KETOADD in your CKD patients? (Please choose more than one, wherever applicable) *

a) It is a good quality brand and I prescribe it frequently in my patients

b) I am aware of this brand and prescribe it often in my patients

c) I am aware of this brand, but not yet prescribed in my patients

d) I am aware of this brand, but prescribe another brand for my patients

What is the usual dosage you prescribe for KETOADD in your day-to-day practice? *

a) 5 to 6 tablets daily in divided dosage

b) 3 tablets daily in divided dosage

c) 12 tablets daily in divided dosage

d) As per recommendation i.e. 1 Tab / 5 Kg body weight in divided dosage

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Survey Questionnaire