Slow adoption of evidence based practices in nephrology

I read with interest Jain and colleagues’ consideration of a screening programme for chronic kidney disease in view of the recent advances in interventions that limit progression of kidney disease and reduce cardiovascular risk in this population.1 But, as the authors imply, one huge challenge remains. Despite approvals from the National Institute for Health and Care Excellence and publication of the UK Kidney Association’s comprehensive guidelines on SGLT2 receptor inhibitors,2 widespread implementation of such high quality evidence is still low.This seems to be a pressing challenge throughout medicine—when clinical advances occur but their uptake lags. To improve patient outcomes and reduce costs in healthcare, it is necessary to implement therapies that have been proved to provide both tangible clinical benefits and cost savings. Why has there been such slow adoption? The proactive intravenous iron therapy in haemodialysis patients (Pivotal) trial, the largest kidney dialysis trial in the UK, was published…
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