Reinforcing the Need for Earlier Testing and Increased Transparent Communication for People Diagnosed with Chronic Kidney Disease Associated with Type 2 Diabetes

Handshake between doctor and patient

To better understand the attitudes and challenges healthcare professionals face in diagnosing, managing and treating people with Chronic kidney disease associated with T2D—and spark conversations about how to improve them—Bayer funded a survey in partnership with MedSurvey, a leading medical market research company. 



Chronic kidney disease (CKD) is a serious and progressive condition that is often underrecognized.(1) It is also a frequent complication arising from type 2 diabetes (T2D) and an independent risk factor of cardiovascular disease (2-4) requiring a collaborative care team. Consistent partnership and communication among healthcare professionals (HCPs) is critical in advancing care for patients with CKD associated with T2D. (5)


When T2D patients are initially diagnosed with CKD, they often receive initial care from their primary care physician (PCP) and are referred to a nephrologist (kidney specialists) only after their CKD has progressed. (6) Research has shown that co-management between a PCP and a nephrologist is associated with improved quality of care, delayed dialysis and more frequent testing for patients. (5)


To better understand the attitudes and challenges HCPs face in diagnosing, managing and treating people with CKD associated with T2D—and spark conversations about how to improve them—Bayer funded a survey in partnership with MedSurvey, a leading medical market research company. 


Findings from the survey, which queried a total of 1000 respondents made up of nephrologists, PCPs, nurse practitioners (NPs) and physician assistants (PAs), revealed agreement among physicians on the need for earlier testing and increased transparent communication for people diagnosed with CKD associated with T2D. (7) 


Key survey findings:

There’s a collective acknowledgement among HCPs that people with T2D need to be tested for CKD earlier and more often, despite results showing that guideline-recommended tests are underutilized. (7) 

  • The majority of HCPs surveyed (80% PCPs, 88% nephrologists, 88% NPs/PAs) agree the medical community could do better and diagnose CKD in people with T2D earlier
    • While a majority of HCPs are using estimated glomerular filtration rate (eGFR) blood tests to assess kidney function at least once every few months (62% PCPs, 80% nephrologists, 77% NPs/PAs), urine albumin-creatinine ratio (uACR) tests are significantly underutilized (30% PCPs, 57% nephrologists, 38% NPs/PAs), clashing with guideline recommendations to test more frequently


HCPs agree that improved communication with patients is needed to enhance care. (7) 

  • More than 4 in 5 HCPs (84%) agree people are often unprepared for their diagnosis
    • The majority of HCPs (88%) agree they need to use clearer and more transparent language when talking about the risk of CKD with people diagnosed with T2D
    • Nearly 9 in 10 HCPs (89%) agree that people diagnosed with T2D don’t understand their increased cardiovascular risk once they are diagnosed with CKD


PCPs and nephrologists have differing opinions on who should be the lead medical professional coordinating treatment and management, resulting in a significant number of patients not being referred to nephrologists earlier, despite the majority of HCPs surveyed agreeing that nephrologists need to be brought in sooner. (7) 


  • While most nephrologists believe they should be the lead HCP in diagnosing and managing CKD patients (58% and 90%, respectively), PCPs see this as their role (88% and 56%, respectively)
  • The vast majority of HCPs (77% PCPs, 90% nephrologists, 89% NPs/PAs) agree nephrologists need to be brought in earlier, yet 88% of PCPs may choose not to refer people with CKD to a nephrologist; the top reasons include: 
    • Two-thirds (59%) believe they can manage CKD themselves 
    • Almost half (45%) feel the patient doesn’t want to see a nephrologist 
    • More than a third (34%) don’t feel their patients’ symptoms require a nephrologist 
  • Over 8 in 10 nephrologists wish they were brought in earlier to diagnose and manage CKD (82% and 89%, respectively), with 3 in 4 (76%) reporting that PCPs may often underestimate the risks and severity of CKD in their T2D patients


Working together to co-manage patients with CKD associated with T2D results in a variety of challenges for HCPs and further confusion for the patient.(7) 


  • The top challenges HCPs face when co-managing patients include: 
    • Patients often become confused about who to go to for what (77%)
    • A lack of timely/centralized communication (64%)
    • Limited access to the other HCP (58%) 
    • Unclear roles and responsibilities between HCPs (58%)


These findings reinforce the importance of our commitment to identifying resources and programs aimed at better understanding the real-world management of CKD and expanding screening and early care management. Together—with healthcare professionals and the broader kidney community—we have an opportunity to improve the diagnosis and management of CKD to truly advance patient care.
German Guerrero, MD
Executive Medical Director, Cardiorenal, Bayer

The survey results will propel Bayer’s continued work to ensure people with CKD associated with T2D receive optimal care that ultimately leads to earlier diagnosis and treatment, and better outcomes.

About the Survey 
Bayer initiated and funded a 15-minute online survey conducted by MedSurvey between January 20 and February 16, 2023. The survey included 1000 U.S. HCPs, including nephrologists (n=200), family medicine/general practice/primary care internal medicine (n=500) and nurse practitioners or physician assistants (n=300) who are duly licensed in the state where they practice and are currently treating people diagnosed with CKD associated with T2D. The survey asked HCPs about their current collaborative care practices and looked to identify barriers and disparities in these practices to improve the treatment of CKD associated with T2D and its associated conditions. The online survey is not based on a probability sample, and therefore, no estimate of theoretical sampling error can be calculated.  

  1. Chronic kidney disease basics. Centers for Disease Control and Prevention. Updated February 28, 2023. Accessed on February 24, 2023.
  2. Anders HJ, Huber TB, Isermann B, et al. CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease. Nat Rev Nephrol. 2018; doi:10.1038/s41581-018-0001-y
  3. Thomas MC, Brownlee M, Susztak K, et al. Diabetic kidney disease. Nat Rev Dis Primers. 2015; doi:10.1038/nrdp.2015.18
  4. Bailey RA, Wang Y, Zhu V, Rupnow MF. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: Improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7(1):415. doi:10.1186/1756-0500-7-415
  5. Skolnik NS, Style AJ. Importance of early screening and diagnosis of chronic kidney disease in patients with type 2 diabetes. Diabetes Ther. 2021;12(6):1613-1630. doi:10.1007/s13300-021-01050-w
  6. Dharod A, Bundy R, Russell GB, et al. Primary care referrals to nephrology in patients with advanced kidney disease. Am J Manag Care. 2020;26(11):468-474. doi:10.37765/ajmc.2020.88526  
  7. Bayer survey conducted by MedSurvey; January 20-February 16, 2023.
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