The primary outcome measure was the proportion of patients successfully attaining at least seven of nine clinical targets 78% (Table 2) (4). The targets were selected based on practice guidelines at the time when patients were being seen in clinic (20-23). For blood pressure and laboratory values, the median of three values was used to determine whether the target was met or not. The target range for blood pressure in the intervention period differed from that of the control period due to the 2004 update of guideline recommendations for optimal blood pressure in patients with chronic kidney disease 130/80 vs. 140/90 . For the target of end-stage renal disease options, the medical record was reviewed to determine whether a discussion took place or not. If the record indicated that treatment option () were discussed or plans for dialysis access were made, then this target was coded as successfully achieved.