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Measurement of nPCR for Pediatric Hemodialysis Patients

CBE ID
1425
Endorsement Status
E&M Committee Rationale/Justification

When the measure returns for maintenance (5 years), the measure developer should have:

  • Aligned with any forthcoming CBE polices around pediatric population measures; and
  • Explored meaningfulness with patients/parents/caregivers that have direct lived experience in this measure area.
1.0 New or Maintenance
1.1 Measure Structure
Previous Endorsement Cycle
Is Under Review
No
Next Maintenance Cycle
Fall 2029
1.6 Measure Description

Percentage of patient months of pediatric (< 18 years old) in-center hemodialysis patients (irrespective of frequency of dialysis) with documented monthly nPCR measurements. 

Measure Specs
General Information
1.7 Measure Type
1.7 Composite Measure
No
1.3 Electronic Clinical Quality Measure (eCQM)
1.8 Level of Analysis
1.9 Care Setting
1.9b Other Care Setting
Dialysis Facility
1.10 Measure Rationale

For in-center hemodialysis patients, nPCR provides an estimate of dietary protein intake, which has been shown to provide additional information to spKt/V. Studies have shown that in adolescent patients who achieved target spKt/V levels, nPCR was associated with nutritional status. Furthermore, there is evidence that nPCR < 1 gram/kg/day is predictive of malnutrition and sustained weight loss among adolescent patients. 

1.20 Types of Data Sources
1.25 Data Source Details

EQRS is the primary basis for placing patients at dialysis facilities and dialysis claims are used as an additional source. Information regarding first ESRD service date, death, age and incident comorbidities adjustments and transplant is obtained from EQRS (including the CMS Medical Evidence Form (Form CMS-2728) and the Death Notification Form (Form CMS-2746)) and Medicare claims, as well as the Organ Procurement and Transplant Network (OPTN) and the Social Security Death Master File.