NQF Endorses Renal Measures 

Washington, DC – the National Quality Forum (NQF) Board of Directors has approved for endorsement 12 quality measures on renal care. The measures address a range of care concerns, for chronic kidney disease, end stage renal disease, and dialysis treatment.

“Estimates show that 31 million people in the United States suffer from chronic kidney disease, often brought on by existing conditions such as cardiovascular disease, diabetes, hypertension, and obesity,” said Janet Corrigan, PhD, MBA, president and CEO of NQF. “These measures will help ensure renal patients receive safe, high-quality, and compassionate care throughout the course of treatment.”

For this project, NQF endorsed measures focused on care concerns such as mortality rates for facility dialysis patients, and hemoglobin levels in chronic kidney disease patients. NQF also endorsed measures related to vascular access and minimum dose with dialysis treatment and lipid profiles in chronic kidney disease patients. In all, 33 measures were evaluated against NQF’s endorsement criteria by a panel of providers, measurement experts, and consumer representatives; 12 measures were endorsed.

“These measures are a welcome addition to the NQF portfolio,” said Peter Crooks, MD, Associate Medical Director for Operations at Southern California Kaiser Permanente and co-chair of the Renal Endorsement Maintenance Steering Committee. “Kidney disease is a major cause of morbidity and mortality in the United States. These measures will help providers better manage dialysis patients and also those patients with earlier stages of kidney disease.”

The endorsed measures include those previously endorsed by NQF and newly submitted measures for initial endorsement. Nine measures were previously endorsed, and three are new. The ongoing evaluation and updating of endorsed measures ensures the currency and relevance of NQF’s renal care portfolio.

“Chronic kidney disease and end stage renal disease are associated with premature mortality, decreased quality of life, and increased healthcare costs,” said Kristine Schonder, PharmD, assistant professor at the University of Pittsburgh School of Pharmacy and co-chair of the Renal Endorsement Maintenance Steering Committee. “This measure set will help improve the quality of care throughout the course of kidney disease and protect renal patients from additional complications, in turn improving their health and well-being.”

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of any of the 12 endorsed quality measures listed below by submitting an appeal no later than May 1 (to submit an appeal, go to the NQF Measure Database). For an appeal to be considered, the notification must include information clearly demonstrating that the appellant has interests directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

Endorsed Measures

Mortality 

• 0369: Dialysis Facility Risk-adjusted Standardized Mortality Ratio (CMS) 

• 1666: Patients on Erythropoiesis Stimulating Agent (ESA)--Hemoglobin Level>12.0 g/dL (AMA-PCPI)
• 1667: (Pediatric) ESRD Patients Receving Dialysis: Hemoglobin Level<10g/dL 13 (AMA-PCPI)

• 1668: Laboratory Testing (Lipid Profile) (AMA)

• 0249: Hemodialysis Adequacy Clinical Performance Measure III: Hemodialysis Adequacy--HD Adequacy--Minimum Delivered Hemodialysis Dose (CMS) 
• 0323: Hemodialysis Adequacy: Solute (AMA-PCPI) 
• 0318: Peritoneal Dialysis Adequacy Clinical Performance Measure III - Delivered Dose of Peritoneal Dialysis Above Minimum (CMS) 
• 0321: Peritoneal Dialysis Adequacy: Solute (AMA-PCPI) 

• 0255: Measurement of Serum Phosphorus Concentration (CMS)

• 0251: Vascular Access—Functional AVF or AV Graft or Evaluation for Placement (Kidney Care Quality Alliance)
• 0256: Hemodialysis Vascular Access- Minimizing use of catheters as Chronic Dialysis Access (CMS)
• 0257: Hemodialysis Vascular Access- Maximizing Placement of Arterial Venous Fistula (AVF) 

NQF operates under a three-part mission to improve the quality of American healthcare by:  

• building consensus on national priorities and goals for performance improvement and working in partnership to achieve them; 
• endorsing national consensus standards for measuring and publicly reporting on performance; and 
• promoting the attainment of national goals through education and outreach programs.