Table 2.
Results of Questionnaires on CKD Medical Care According to the Utilization of SGLT2 Inhibitors.
| Active user group | Passive user group | p Value† | ||
|---|---|---|---|---|
| (n = 508) | (n = 316) | |||
| Q1 | Do you possess the CKD guidelines 2023? | |||
| Yes, and I use them frequently. | 121 (23.8)# | 52 (16.5)# | 0.02 | |
| Yes, but I have not used them. | 175 (34.4) | 106 (33.5) | ||
| No, but I would like to obtain the CKD Guidelines 2024 for GPs. | 176 (34.6) | 121 (38.3) | ||
| I do not possess them and do not wish to obtain the CKD Guidelines 2024 for GPs. | 32 (6.3)＊ | 35 (11.1)＊ | ||
| No answer. | 4 (0.8) | 2 (0.6) | ||
| Q2* | What parameters do you use to assess kidney function? | |||
| Serum creatinine level. | 291 (57.3) | 203 (64.2) | 0.048 | |
| eGFRcreatinine level. | 491 (96.7) | 289 (91.5) | 0.001 | |
| Serum cystatin C level. | 74 (14.6) | 33 (10.3) | 0.09 | |
| eGFRcystatinC level. | 81 (15.9) | 24 (7.6) | < 0.001 | |
| Creatinine clearance (24-h urine collection). | 12 (2.4) | 9 (1.9) | 0.66 | |
| Q3 | How do you diagnose patients as having CKD? | |||
| Only by urine test. | 2 (0.4)# | 6 (1.9)# | < 0.001 | |
| Only by eGFR level. | 29 (5.7)# | 41 (13.0)# | ||
| By both urine test and eGFR level. | 370 (72.8) | 234 (74.1) | ||
| By urine test, eGFR level, and kidney imaging. | 104 (20.5)# | 33 (10.4)# | ||
| No answer | 3 (0.6) | 2 (0.6) | ||
| Q4 | Do you check urine tests for patients with CKD during regular visits? | |||
| Perform quantitative tests for proteinuria (g/gCr). | 203 (40.0)# | 170 (53.8)# | < 0.001 | |
| Perform only qualitative tests for proteinuria. | 205 (40.4)# | 84 (26.6)# | ||
| Do not perform urine testing. | 10 (2.0) | 11 (3.5) | ||
| No answer | 90 (17.7) | 51 (16.1) | ||
| Q5 | Do you check albuminuria in patients with diabetes during regular visits? | |||
| Quantitative tests every 3 months. | 102 (20.1)# | 40 (12.7)# | < 0.001 | |
| Quantitative tests once or twice a year. | 216 (42.5)# | 76 (24.1)# | ||
| Rarely perform quantitative tests. | 75 (14.8)# | 69 (21.8)# | ||
| Perform only qualitative tests. | 32 (6.3) | 30 (9.5) | ||
| Do not check albuminuria. | 82 (16.1)# | 100 (31.6)# | ||
| No answer | 1 (0.2%) | 1 (0.3) | ||
| Q6 | Do you evaluate BP in patients with CKD during clinic visits? | |||
| I evaluate both office BP and home BP in the early morning. | 444 (87.4)# | 259 (82.0)# | 0.01 | |
| I evaluate only home BP in the early morning. | 27 (5.3) | 14 (4.4) | ||
| I evaluate only office BP. | 36 (7.1)# | 38 (12.0)# | ||
| I do not evaluate either. | 0 (0.0)# | 5 (1.6)# | ||
| No answer | 1 (0.2) | 0 (0.0) | ||
| Q7 | Do you prescribe RAS inhibitors to patients with CKD and hypertension? | |||
| I prescribe them as first-line medication. | 393 (77.4)# | 222 (70.3)# | < 0.001 | |
| I prescribe them to patients with proteinuria. | 93 (18.3) | 54 (17.1) | ||
| I rarely prescribe them. | 20 (3.9)# | 39 (12.3)# | ||
| No answer | 2 (0.4) | 1 (0.3) | ||
| Q8* | When do you discontinue RAS inhibitors in patients with CKD? | |||
| When kidney function deteriorates. | 178 (35.3) | 125 (39.8) | 0.20 | |
| When the serum Cr level reaches 2 mg/dL. | 122 (24.2) | 72 (22.9) | 0.68 | |
| When the serum potassium level exceeds the normal range. | 225 (44.6) | 152 (48.4) | 0.29 | |
| I continue prescribing them for their renoprotective effects. | 245 (48.6) | 127 (40.4) | 0.02 | |
| I do not prescribe them to patients with CKD. | 7 (1.4) | 16 (5.1) | 0.002 | |
| Q9* | How do you evaluate salt intake in patients with CKD? | |||
| By Tanaka’s formula using spot urine samples. | 198 (40.1) | 74 (24.3) | < 0.001 | |
| By direct measurement using 24-h urine collection. | 2 (0.4) | 6 (2.0) | 0.03 | |
| By patient interview. | 164 (33.2) | 114 (37.4) | 0.23 | |
| I do not evaluate salt intake by either method. | 143 (28.9) | 120 (39.3) | 0.002 | |
| Q10* | Which parameters do you use to evaluate renal anemia? | |||
| Hemoglobin level. | 500 (98.4) | 300 (95.2) | 0.007 | |
| Mean corpuscular volume (MCV). | 301 (59.3) | 144 (45.7) | < 0.001 | |
| Serum iron (Fe) level. | 362 (71.3) | 194 (61.6) | 0.004 | |
| Transferrin saturation (TSAT). | 162 (31.9) | 47 (14.9) | < 0.001 | |
| Serum ferritin level. | 362 (71.3) | 187 (59.4) | < 0.001 | |
| Serum erythropoietin level. | 232 (45.7) | 148 (47.0) | 0.71 | |
| Q11 | Do you prescribe erythropoiesis-stimulating agents to patients with CKD? | |||
| Yes, I prescribe them at my own discretion. | 347 (68.3)# | 165 (52.2)# | < 0.001 | |
| Yes, I prescribe them when recommended by a nephrologist. | 92 (18.1)# | 83 (26.3)# | ||
| No, I do not prescribe them. | 63 (12.4)# | 63 (19.9)# | ||
| No answer | 6 (1.2) | 5 (1.6) | ||
| Q12 | Do you prescribe HIF-PH inhibitors to patients with CKD? | |||
| Yes, I prescribe them at my own discretion. | 306 (60.2)# | 110 (34.8)# | < 0.001 | |
| Yes, I prescribe them when recommended by a nephrologist. | 102 (20.1) | 78 (24.7) | ||
| No, I do not prescribe them. | 87 (17.1)# | 118 (37.3)# | ||
| No answer | 13 (2.3) | 10 (3.2) | ||
| Q16 | How do you manage serum potassium levels in patients with CKD? | |||
| I regularly check potassium levels and manage hyperkalemia continuously. | 333 (65.6)# | 150 (47.5)# | < 0.001 | |
| I check potassium regularly but provide only temporary treatment. | 82 (16.1)# | 73 (23.1)# | ||
| I check potassium regularly but refer hyperkalemia management to a nephrologist. | 62 (12.2)# | 57 (18.0)# | ||
| I do not check potassium but manage hyperkalemia per nephrologist instructions. | 24 (4.7)# | 26 (8.2)# | ||
| I neither check nor treat hyperkalemia. | 7 (1.4) | 10 (3.2) | ||
| Q18 | Do you evaluate serum calcium and phosphorus levels in patients with CKD? | |||
| I regularly check both calcium and phosphorus levels. | 258 (50.8)# | 106 (33.5)# | < 0.001 | |
| I regularly check only calcium levels. | 119 (23.4) | 82 (25.9) | ||
| I check them only in patients on vitamin D therapy. | 65 (12.8) | 39 (12.3) | ||
| I do not check them but rely on nephrologists. | 45 (8.9)# | 63 (19.9)# | ||
| I never check them. | 16 (3.1)# | 26 (8.2)# | ||
| No answer | 5 (1.0) | 0 (0.0) | ||
| Q19 | Do you provide dietary therapy to patients with non–dialysis-dependent CKD? | |||
| I provide it at my clinic or hospital. | 345 (67.9)# | 159 (50.3)# | < 0.001 | |
| I refer patients to nephrologists for dietary therapy. | 107 (21.1)# | 96 (30.4)# | ||
| I neither provide nor refer for dietary therapy. | 53 (10.4)# | 61 (19.3)# | ||
| No answer | 3 (0.6) | 0 (0.0) | ||
| Q20* | What types of CKD dietary therapy do you provide? | |||
| Restriction of daily salt intake. | 479 (96.8) | 284 (94.0) | 0.06 | |
| Restriction of daily protein intake. | 322 (65.1) | 189 (62.6) | 0.48 | |
| Guidance on appropriate daily calorie intake. | 171 (34.5) | 89 (29.5) | 0.14 | |
| Restriction of daily phosphate intake. | 223 (45.1) | 97 (32.1) | < 0.001 |
Values are expressed as n (%).
BP: blood pressure; CKD: chronic kidney disease; Cr: creatinine; eGFR: estimated glomerular filtration rate; GP: general practitioner; HIF-PH: hypoxia-inducible factor prolyl hydroxylase; Q: question; RAS: renin–angiotensin system; SGLT2: sodium–glucose cotransporter 2.
†p values were calculated using the chi-square test.
＊Multiple responses were allowed where indicated.
# Significant differences were observed after Bonferroni correction.