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A nephrolog ist provider sees each patient receiving hemodialysis weekly; for peritoneal dialysis patients, monthly appointments are standard. Nephrologists ensure all dialysis patients are current with necessary tests and, as appropriate, help optimize their health prior to kidney transplantation. Patients on dialysis are living longer and better, but their best hope for long-term survival is receiving a donor kidney, according to Dr. Ondocin. "We work collaboratively with trans- plant programs in the region to ensure patients receive appropriate care," says Adebowale Oguntola, MD, nephrologist at Nephrology Associates. "We have a refer- ral network of specialists that helps us with the multidisciplinary approach nec- essary for this level of patient complexity." ALL-ENCOMPASSING CARE Nephrology Associates offers a variety of services and programs to complement its providers' clinical expertise, including: + An award-winning, on-site labo- ratory. Located in the flagship office in Syracuse, Nephrology Associates' laborator y, under the direction of nephrologist Simardeep Mangat, MD, recent ly received t he Laborator y Excellence Award from COLA, a leading laboratory accreditation organization. "Having an in-house laboratory makes our jobs easier by giving us quick access to the information we need to make medical decisions," Dr. Oguntola says. "For the laboratory to be recognized by a national regulatory body such as COLA, which con- ducted a rigorous on-site survey as part of the evaluation process for the Laboratory Excellence Award, is something we're quite proud of." + An anemia and iron clinic. Anemia and diminished iron levels are com- mon problems for individua ls with CKD. Nephrolog y Associates offers in-office subcutaneous injections of the drug Aranesp and intravenous infu- sions of the drug Venofer in Syracuse to help patients avoid the need for blood transfusions. + A vaccination program. CKD can Collaborating to Care for Complex Patients IT IS V IRTUA LLY impossible to treat any chronic condition in a vacuum, and that is especially true of chronic kidney disease (CKD). Individuals with CKD often have comorbidities, such as hypertension, diabetes and coronary artery disease, which require collaborative management by disparate clinicians, including nephrologists. Multidisciplinary care is characteristic of Nephrology Associates of Syracuse, PC. Early referral by primary care physicians and other providers is key to the success of CKD management and one of the chief reasons why patients are living longer than in the past, according to Adebowale Oguntola, MD, nephrologist at Nephrology Associates. "When I joined the practice in 2000, most of the time, we'd receive referrals when patients were close to requiring dialysis," he says. "Now, many physicians know the sooner they refer to us, the better, as many symptoms associated with kidney disease, such as anemia and mineral and bone disorder, are quite subtle. The number of patients in their 90s whom I see in the practice now compared with a decade ago has significantly increased. That no longer surprises me, but it's been a big shift." Managing a patient who may have co-occurring CKD and coronary artery disease or diabetes requires continual physician-to-physician communication about a variety of factors that may affect his or her care, such as adjustments to medication dosages. "What helps set Nephrology Associates apart is that we communicate frequently with other providers — not just through notes, but also via phone and face to face," says Philip Ondocin, MD, nephrologist at Nephrology Associates. "Other physicians receive copies of our notes and lab test results, and if an issue requires more attention, I follow up with a phone call to be sure they're aware of it. It's so important to the quality of care to ensure everyone is on the same page." It also gives patients peace of mind. "One of the first things I tell patients when they come to see me is they should be assured that everything I tell them will be summarized and a synopsis sent to their family physician," Dr. Oguntola says. "That puts them at ease, knowing they don't have to remember a lot of technical things to tell their physician." Jackie Spencer, NP, and Joanna Woodruff, NP M D N E W S . C O M /// M D N E W S C E N T R A l N E W Y O R K ■ 2 019 1 5