DigiCon

What is the preferred staging method you use for classifying your CKD patients? *

As per Stage 1 – 5 (Based on GFR)

As per the CKD cause, GFR and albuminuria category (Based on KDIGO 2013 guidelines

Do not follow any categorisation method

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

How do you assess the patient of CKD? *

eGFR

Urine test (albuminuria)

X=ray

Imaging studies

USG

CT scan

MRI

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

Slow the rate of disease progression to complete kidney failure

Preservation and optimization of renal function

Prevention/ treatment of complications and other medical conditions

Achieve/ maintain optimal nutritional status

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) *

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

Individualize BP targets and agents according to disease and other comorbidities

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

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

Avoid nephrotoxic medications to prevent worsening renal function.

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

According to your clinical experience, does nutrition play an important role in reducing the progression of CKD in patients? *

Yes

No

Can’t say Not proven clinically

No experience as yet

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? *

Yes

No

Any other scale

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

Oral nutritional supplements

Enteral feeding (In select cases)

Parenteral nutritional support

Growth hormone

Exercise in combination to nutrition

Appetite stimulants

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

Refer to Specialist renal dietician

What is your opinion of using “Febuxostat or xanthine oxidase inhibitors” in CKD patients with hyperuricemia? *

Yes, I prescribe in my patients

Yes, I aware of Xanthine Oxidase Inhibitors, but have not yet prescribed in my patients

No, I am not sure about the use of Xanthine Oxidase Inhibitors in CKD patients

No, I am not convinced about the benefits of Xanthine Oxidase in CKD patients

No experience as yet

In case you are prescribing xanthine oxidase inhibitors in your patients, kindly share the reasons for the same. (Based on your response to Q9) (Please choose more than one, wherever applicable) *

It gets you on top of hyperuricemia CKD vicious cycle

It retards more renal disease progression effectively

It provides additional renal protection

All of the above

In case you are NOT prescribing Xanthine Oxidase Inhibitors in your patients, kindly share the reasons for the same. (Based on your response to Q9) (Please choose more than one, wherever applicable) *

Lack of clinical evidence for the benefits

No significant effect in preserving the renal function

It increases the pill-burden in my patients

It is not cost-effective

The KDIGO 2020 Nutrition in CKD guideline recommends inclusion of keto-analogues in Low protein diet or very low protein diet in CKD patients not on dialysis and without diabetes. What is your opinion on the above? *

I agree with the recommendation, and hence I prescribe keto-analogues in my patients

I am aware, but do not prescribe keto-analogues in my patients

Most of my CKD patients have co-morbid diabetes

I do not follow this recommendation

How many of your hyperuricemia patients with CKD are on Febuxostat? *

30%

50%

60%

>60%

How many of your hyperuricemia patients with CKD are on Allopurinol? *

30%

50%

60%

>60%

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

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

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

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

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

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

Febuget 40

Febuget 80

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Survey Questionnaire