Safe Patient Care in CKD: Core Curriculum 2025

Prasheen Shah, Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine; School of Medicine, Tufts University, Boston, Massachusetts.
Hassan Mahmoud, Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine; School of Medicine, Tufts University, Boston, Massachusetts.
Grant Oakley, Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine; School of Medicine, Tufts University, Boston, Massachusetts.
Mark G. Parker, Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine; Department of Quality and Safety, Maine Medical Center, Portland, Maine; School of Medicine, Tufts University, Boston, Massachusetts. Electronic address: Mark.Parker@mainehealth.org.

Abstract

Quality and safety in health care have garnered scrutiny in recent decades. Complete prevention of unintended harm remains elusive. Patients with chronic kidney disease are at risk for adverse events because of the complexity of this illness and the impact of declining kidney function on choices for diagnostic studies and therapies. Nephrologists must be knowledgeable about patient safety principles and methods for evaluating harm or near harm events and be prepared to learn from investigations to make improvements. Medication safety is particularly challenging in the context of progressive kidney disease, and safety has increased in scope due to the broader choices of therapeutics for such conditions as diabetic nephropathy and anemia of chronic kidney disease. Radiologic imaging and procedural safety are also influenced by impairment of kidney function. Technological applications for patient safety are evolving and hold promise for mitigating human error and engaging patients as partners in care. In this Core Curriculum, we address essential nephrologist competency for maintaining patient safety in chronic kidney disease.