The Choosing Wisely RI campaign promotes productive conversations between patients and doctor--conversations that research shows produce the right level of care and go a long way towards eliminating tests, procedures and medications that provide, little, if any benefit. The campaign is organized and promoted by the Rhode Island Business Group on Health (RIBGH) and draws on the expertise of the American Board of Internal Medicine Foundation. While we provide materials that enable patients to have informed conversations with their doctors and other health care providers, we do not provide any individual medical advice.
Choosing Wisely provides employees free-of-charge access to online tools developed by ABIMF and their 80+ Specialty Society partners.
The Choosing Wisely Mobile Phone App for Apple and Android phones gives employees the chance to view the Choosing Wisely materials and recommendations on their phones - possibly when they are in their physician's office!
Get daily updates from Choosing Wisely RI on our Facebook page!
Join the more than 40 organizations who have already adopted Choosing Wisely. Launching the campaign for Your Employees is Easy!
Chronic Kidney Disease
Making Hard Choices
March is National Kidney Month. In honor of this observance, we have included Choosing Wisely's recommendations on chronic kidney disease from The American Society of Nephrology.
Kidneys remove waste and extra water from the blood in your body, which leave your body as urine. Chronic kidney disease moves slowly from early stages (stages 1 and 2), which usually have no symptoms, to advanced stages (stages 3, 4, and 5).
If you or a family member have chronic kidney disease, it may not be easy or clear how to choose among the many tests and treatments available.
Here are The American Society of Nephrology's recommendations on four different treatments offered for chronic kidney disease:
1. Anemia Drugs
According to the The American Society of Nephrology, you should consider erythropoiesis-stimulating agents (ESAs) only if you have symptoms of anemia, such as feeling tired or short of breath, and you also have a very low hemoglobin level under 10g/dl. If you and your doctor decide to try an ESA, you should take the lowest dose that relieves your symptoms and keeps your hemoglobin level just high enough that you do not need blood transfusions.
2. Intravenous Catheters
According the The American Society of Nephrology, if your kidney disease reaches stage 3 or higher and a doctor suggests a "peripherally inserted central catheter" (PICC) in your arm, ask for a second opinion from a doctor who specializes in kidney diseases. Often, you can have the PICC put in a vein in your neck instead, which saves the veins in your arms for use with hemodialysis.
Dialysis takes over some of the things your kidneys normally do, like removing waste and keeping a safe balance of water and salts in your blood. However, to The American Society of Nephrology, hemodialysis does not always relieve your symptoms and it may not help you do your normal activities, stay independent, or live longer. Ask your doctor to tell you all the benefits and risks of hemodialysis. Ask how well hemodialysis will manage your symptoms and how it will affect your lifestyle. And ask how your symptoms would be managed if you do not start hemodialysis.
4. Cancer screenings if you are on hemodialysisAccording to The American Society of Nephrology, routine screenings like colonoscopies, mammograms, and Pap smears can save lives by finding cancer early on. However, if you are on hemodialysis, other health problems have higher risks and need more attention than a possible cancer. Advanced kidney disease can also change the body in ways that make cancer screenings less accurate. Before deciding whether to have routine cancer screenings, consider your risk factors for cancer, any symptoms you have, and how long hemodialysis is expected to keep you alive.