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Calcium and vitamin D were used by 91% of nephrologists most or all of the time for prevention of osteoporosis in patients on steroids, while there was substantial variability in the use of bisphosphonates for the same indication. Pneumocystis jiroveci pneumonia UNC2881 prophylaxis in patients on high-dose immunosuppression was used by 83% of nephrologists most or all of the time. There were no differences in these components of the conservative management of GN between physician characteristics (duration of clinical practice or practice environment). Table 3. Self-reported use of non-immune therapies in the management of patients with GN Barriers to the management of GN patients To investigate potential barriers to the implementation of best-practice management of GN, the survey asked about the availability of different clinical resources and tools. Summary sheets of previously tried immunosuppression therapies and previous biopsy AP24534 purchase results were available to 31 and 23% of nephrologists, respectively, whereas standardized laboratory requisitions and immunosuppression protocols were available to 44 and 25%. As shown in Table ?Table4,4, most physicians had access to other clinicians for a second opinion. However, the availability of patient-focused Selleckchem STI571 education tools and nursing support was either unknown or poor for 87 and 67% of nephrologists, respectively. Web-based decision support was readily accessible to only 43% of physicians. Despite Canada having universal healthcare, insurance coverage for immunosuppression medications for patients with GN was poorly accessible to 84% of physicians. Table 4. The availability of clinical support tools for the management of patients with GN, rated on a scale from 1 (not available) to 5 (very available). Compared with non-academic urban or rural physicians, those working in academic environments had better access to other clinicians for a second opinion (95 versus 63�C69% P