Table 3.
Results of Questionnaires on CKD Collaborative Care between GPs and Nephrologists According to the Utilization of SGLT2 Inhibitors.
| Active user group | Passive user group | p Value† | ||
|---|---|---|---|---|
| (n = 508) | (n = 316) | |||
| Q21 | Is CKD collaborative care between GPs and nephrologists active in your region? | |||
| Yes, fully active. | 128 (25.2) | 71 (22.5) | 0.64 | |
| Yes, partially active. | 234 (46.1) | 149 (47.2) | ||
| No, it does not work well. | 108 (21.3) | 64 (20.3) | ||
| No, and there is no CKD collaborative care between GPs and nephrologists. | 36 (7.1) | 31 (9.8) | ||
| No answer | 2 (0.4) | 1 (0.3) | ||
| Q22 | Do you know any nephrologists whom you can consult regarding patients with CKD? | |||
| Yes, I know several nephrologists available for consultation. | 385 (75.8) | 241 (67.3) | 0.09 | |
| Yes, I know only one nephrologist available for consultation. | 71 (14.0) | 31 (9.8) | ||
| No | 48 (9.4) | 43 (13.6) | ||
| No answer | 4 (0.8) | 1 (0.3) | ||
| Q23 | How is your relationship with nephrologists available for consultation? | |||
| I know them well personally. | 169 (33.3)# | 71 (22.5)# | 0.003 | |
| I know only their names. | 277 (54.5) | 190 (60.1) | ||
| I do not know them well. | 58 (11.4)# | 54 (17.1)# | ||
| No answer | 4 (0.8) | 1 (0.3) | ||
| Q24 | Do you use the referral criteria for CKD consultation recommended in the CKD Guidelines (Japanese Society of Nephrology)? | |||
| I use it often. | 86 (16.9) | 38 (12.0) | 0.004 | |
| I use it sometimes. | 230 (45.3)# | 120 (38.0)# | ||
| I rarely use them. | 100 (19.7) | 64 (20.3) | ||
| I know about them but do not use them. | 70 (13.8)# | 73 (23.1)# | ||
| I do not know about them. | 19 (3.7) | 19 (6.0) | ||
| No answer | 3 (0.6) | 2 (0.6) | ||
| Q25* | For which patients with CKD do you usually consult nephrologists? | |||
| With evident proteinuria (> 0.5 g/gCr) | 294 (59.6) | 187 (59.4) | 0.94 | |
| With both proteinuria and hematuria | 250 (50.7) | 117 (37.1) | < 0.001 | |
| With eGFR < 45 mL/min/1.73 m2 | 313 (63.5) | 218 (69.2) | 0.10 | |
| With rapid eGFR decline | 420 (85.2) | 264 (83.8) | 0.60 | |
| With worsening symptoms including edema | 208 (42.2) | 155 (49.2) | 0.05 | |
| With worsening control of blood pressure or glucose | 87 (17.6) | 72 (22.2) | 0.07 | |
| With need for dietary counseling | 128 (26.0) | 90 (28.6) | 0.42 | |
| With need for explanation of kidney replacement therapy or conservative kidney management | 313 (63.5) | 173 (54.9) | 0.02 | |
| Q28* | What CKD-related treatments would you like nephrologists to provide? | |||
| Salt reduction counseling | 192 (39.0) | 121 (37.7) | 0.92 | |
| CKD-specific dietary counseling | 326 (66.3) | 221 (70.6) | 0.20 | |
| Management of blood pressure | 124 (25.2) | 112 (35.8) | 0.001 | |
| Management of plasma glucose | 60 (12.2) | 58 (18.5) | 0.01 | |
| Treatment for renal anemia | 181 (36.8) | 149 (47.6) | 0.002 | |
| Treatment of electrolyte abnormalities or metabolic acidosis | 289 (58.7) | 188 (60.1) | 0.71 | |
| Explanation of kidney replacement therapy or conservative kidney management | 412 (83.7) | 265 (84.7) | 0.73 | |
| Q29 | Are you satisfied with nephrologists’ CKD consultation? | |||
| Completely satisfied | 129 (26.1) | 58 (18.4) | 0.11 | |
| Satisfied sometimes | 214 (43.2) | 150 (47.6) | ||
| Neither satisfied nor dissatisfied | 114 (23.0) | 84 (26.7) | ||
| Occasionally dissatisfied | 28 (5.7) | 18 (5.7) | ||
| Not satisfied at all | 6 (1.2) | 1 (0.3) | ||
| No answer | 4 (0.8) | 4 (1.3) | ||
| Q30* | Which aspects of the consultation were unsatisfactory? | |||
| Insufficient patient counseling or explanation | 60 (12.2) | 34 (10.9) | 0.57 | |
| Insufficient feedback to GPs | 83 (16.8) | 51 (16.3) | 0.84 | |
| Inadequate treatment (e.g., no change in medication) | 99 (20.1) | 59 (18.8) | 0.67 | |
| Insufficient counseling by nutritionists or pharmacists | 48 (9.7) | 31 (9.9) | 0.94 |
Values are expressed as n (%).
CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; GP: general practitioner; Q: question; 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.