Adult Kidney Disease: Blood Pressure Management
Percentage of patient visits for those patients aged 18 years and older with a diagnosis of chronic kidney disease (CKD) (stage 3, 4, or 5, not receiving Renal Replacement Therapy [RRT]) with a blood pressure < 140/90 mmHg OR >= 140/90 mmHg with a documented plan of care.
ACP does not support QPP 122: “Adult Kidney Disease: Blood Pressure Management.” We cannot estimate the clinical impact based on the information provided by the measure developers and the measure lost NQF endorsement due to a lack of evidence. The American College of Physicians (ACP) guideline states that there is no difference in outcomes between strict blood pressure control and standard blood pressure control (128-133 mmHg vs. 134- 141 mmHg systolic, and 75-81 mmHg vs. 81-87 mmHg diastolic). Also, the measure specifications do not align with clinical recommendations on disease classification. The Renal Association recommends clinicians stratify stage 3 kidney disease into 2 groups (3a or 3b). Furthermore, the denominator population includes all patients with stage 3 kidney disease and above. It is burdensome for clinicians to document a care plan for all patients classified as stage 3 and above without evidence to support the benefit of the intervention on clinical outcomes.