Ever since I was a medical student, I have found the kidney to be one of the most fascinating organs. However, despite years of active medical practice, I still find the kidney to be a bit of a “black box” to understand. Chronic kidney disease (CKD) is a major medical issue facing our country. CKD is the #9 cause of death in the United States and effects nearly 5 million people per 2017 CDC statistics. This has resulted in nearly 500,000 dialysis patients and 200,000 kidney transplant patients according to the National Kidney Foundation.
To help both providers and patients, the National Kidney Foundation has released numerous free and handy apps for acute and chronic kidney disease. Their website contains links to apps, tools, and guidelines for both primary care providers and nephrologists. On iMedicalApps, we have previously reviewed some of their apps and summarized those we recommend here. The latest app from the National Kidney Foundation is called Chronic Kidney Disease (CKD) Care. The app calculates eGFR and based on other input including the albumin creatinine ratio, demographics and urinary findings generates a differential diagnosis for a specific patient. The app contains quick reference guides for each of these diagnoses based on NKF guidelines.
You are seeing in clinic and evaluating a 75 year old female with known CKD who reports she has been feeling more fatigued than usual and notes some increased lower extremity swelling. You obtain labs which demonstrate a serum Cr of 3.5 (baseline 2.0) and albumin creatinine ratio of 250 with casts noted in her urinalysis. What is your differential diagnosis for this patient?
Chronic Kidney Disease (CKD) Care from the National Kidney Foundation is written by nurse practitioners and nephrologists. The app’s purpose is to help providers care for patients with CKD, AKI and/or at-risk for those conditions. The app is based on guidelines from the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) and the Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. The Quick Reference sections are the best part of the app and include links to UpToDate articles.
Who would benefit from this App?
Any healthcare provider who takes care of patients with acute and chronic kidney diseases including students, residents, primary care, emergency medicine and critical care providers.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Calculates eGFR, adjusted eGFR with primary diagnosis and differential for each case.
- Includes expanded guidelines for each diagnosis/differential and links to UpToDate.
- Available for Android.
- Not all abbreviations defined/described.
- Doesn’t highlight/list what information wasn’t completed when making calculations.
- Goals of care section pretty anemic and could be expanded.
- References and guidelines not hyperlinked or included as PDFs in app.
Chronic Kidney Disease Care from the National Kidney Foundation continues the tradition of quality, handy, and free apps from that organization. The app provides basic eGFR calculation with an expanded differential diagnosis and quick reference guide for a variety of kidney diseases. However, the app lacks significant detail for many diagnoses and doesn’t contain full guidelines, but does contain links to UpToDate articles. The section on goals of care is especially disappointing with a lack of detail/recommendations.
- Overall Score
- User Interface
Interface is pretty intuitive, but lacks some definitions and fails to tell you what box you didn’t click.
- Multimedia Usage
The app includes a handy quick reference section, but does not include full guidelines or links.
App is free.
- Real World Applicability
CKD Care allows for calculation of eGFR which is already available on numerous other calculator apps. It does provide a nice differential diagnosis with quick reference material for each diagnosis/differential. However, for more detail on each of these items, we would recommend a more robust resource such as UpToDate, Dynamed or Essential Evidence. The lack of complete kidney disease guidelines limits the full use of the app.
- Device Used For Review
iPhone 6S running iOS 10.3.2
- Available for DownloadAndroidiPhoneiPad