2024-P: Improving Diabetic Nephropathy Screening in Primary Care Clinics

Introduction and Objective: The prevalence of diabetic nephropathy is approximately 33% of people with diabetes in the United States. With newer therapies available to improve nephropathy, it is essential that screening occurs consistently. Diabetic nephropathy screening includes both a serum estimated glomerular filtration rate (eGFR) and urine microalbumin (uaCR) measurement at minimum annually and more often based on risk. Studies have shown that the national average completion rate in the United States of at least one of these tests annually is 56.5% and only 24.9% for both tests. The primary care clinics of Parkland Health, one of the largest safety-net health systems in the United States, are located in the underserved areas of Dallas County that also see the highest prevalence of diabetes in the county. The average annual screening rate for diabetic nephropathy, using both the eGFR and uaCR measurements, of the 44 primary care providers in these clinics were on average 48% in 2023. The purpose of this project was to improve the screening rate for diabetic nephropathy in the primary care clinics of Parkland Health. Methods: We reported quarterly data to each primary clinic site, had monthly discussions with all of the clinic sites’ leadership to collaboratively to brainstorm methods of improving screening, and provided education about the importance of diabetic nephropathy screening and review of guideline-directed treatments to improve screening rates. Results: By the end of 2025, diabetic nephropathy screening rates using both the eGFR and uaCR measurements improved to 86% (p0.05). Conclusion: By using simple quality improvement tools, Parkland Health was able to establish high rates of diabetic nephropathy screening in the most vulnerable populations in the county. Disclosure U. Gunasekaran: None.