| Course | PA 626 Clinical Clerkship: Elective I |
|---|---|
| Week | 7 |
| Paper type | Directed reading brief |
| Length | About 470 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 626 Week 7
Directed Reading Brief: Does Empagliflozin Still Slow Kidney Decline When eGFR Is Between 20 and 30? A Question From Clinic, Settled by One Trial, With a Paragraph on How It Fits the Patients Seen Here
Student Name
Chamberlain University
PA 626: Clinical Clerkship: Elective I
Instructor Name
Month Day, Year
Directed Reading Brief: Does Empagliflozin Still Slow Kidney Decline When eGFR Is Between 20 and 30? A Question From Clinic, Settled by One Trial, With a Paragraph on How It Fits the Patients Seen Here
Where the Topic Came From
On October 14 the attending kept empagliflozin for a patient whose eGFR had fallen to 24, and a visiting resident asked whether it still did anything at that level. Nobody in the room answered with a number. That is the question this reading settles.
Narrow Enough to Settle
Question: in adults with chronic kidney disease and an eGFR between 20 and 30, does empagliflozin slow progression compared with placebo?
Narrowing it this far rules out the broader questions the resident might also have meant, such as cardiac benefit or use after transplant, which the trial did not test.
What the Trial Found
The EMPA-KIDNEY trial randomized 6,609 adults with an eGFR of 20 to 44, or 45 to 89 with substantial albuminuria, to empagliflozin 10 mg or placebo. Over a median of two years, the composite of kidney disease progression or cardiovascular death occurred in 13.1 percent with empagliflozin and 16.9 percent with placebo, a hazard ratio of 0.72. The benefit was consistent across eGFR subgroups and in people with or without diabetes (EMPA-KIDNEY Collaborative Group, 2023).
Not an Appraisal Exercise
I am not appraising the trial line by line. I read it to answer one practical question, and it answers it: the lowest eGFR band enrolled, starting at 20, showed benefit consistent with the whole trial.
The Fit Paragraph
Patients in this clinic match the trial reasonably well: most have diabetic kidney disease in stages 3b and 4, many on ACE inhibitors, as in the trial. The 2024 guideline advises an SGLT2 inhibitor when the eGFR is 20 or above in chronic kidney disease, continuing them if the eGFR later falls below 20 unless they are not tolerated or kidney replacement begins (Stevens et al., 2024). The patient with an eGFR of 24 fits squarely.
Ending on Something Usable
For the clinic's note template: "SGLT2 inhibitor: start or continue if eGFR 20 or above; continue below 20 if tolerated and not on dialysis." I offered this to the attending, who added it to the clinic's quick reference sheet.
The attending also asked me to check whether the trial reported more low blood pressure or genital infections at low filtration; it did not report a different safety pattern in that group, so the sheet carries no extra warning.
References
EMPA-KIDNEY Collaborative Group. (2023). Empagliflozin in patients with chronic kidney disease. New England Journal of Medicine, 388(2), 117-127. https://doi.org/10.1056/NEJMoa2204233
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., Lamb, E., Lin, P., Madero, M., McIntyre, N., Morrow, K., Roberts, G., Sabanayagam, D., Schaeffner, E., Shlipak, M., . . . Levin, A. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International, 105(4S), S117-S314. https://doi.org/10.1016/j.kint.2023.10.018
What the PA 626 Week 7 assignment asks for
The seventh week asks for a directed reading brief of two or three pages that opens with the service rather than the topic. Say where the question came from: a patient seen that week, a disagreement or a question nobody could answer. Narrow it until one or two sources can settle it. This is not a critical appraisal exercise; read to answer the question. Write a fit paragraph that compares the study's patients with your service's patients. End on something usable, such as a line for a template or a reference sheet. If nobody handed you a topic, pick one that came up in clinic. The brief can disagree with what the service does if the reading supports it. Cite the sources read.
Inside the PA 626 Week 7 example
The opening records an October 14 decision to keep empagliflozin at an eGFR of 24 and a resident's unanswered question. The question is narrowed to eGFR 20 to 30. The findings section summarizes the 2023 EMPA-KIDNEY report: 6,609 patients, two years, 13.1 against 16.9 percent for progression or cardiovascular death and benefit across eGFR bands and diabetes status. A short section explains reading to answer, not to appraise. The fit section compares the clinic's stage 3b and 4 diabetic patients on ACE inhibitors with the trial and cites Stevens et al. (2024) on starting at 20 or above and continuing below. The ending offers a template line the attending added to the reference sheet.
Reading the PA 626 Week 7 grading rubric
The brief is judged first on its origin. A reading that starts from a general topic, with no link to something that happened on the service, earns little. Next comes a question narrow enough for the sources to settle; broad questions produce summaries rather than answers. The fit paragraph is weighted heavily, because a trial is only useful if its patients resemble the service's. Ending on a usable product, such as a template line, earns credit. Faculty do not expect a full appraisal but do expect accurate numbers from the source. Citations should be in APA form.
PA 626 Week 7 help from the desk
Directed reading briefs commonly become literature reviews on a broad topic, with no question from the service and no answer at the end. Another frequent gap is skipping the comparison between the study's patients and the clinic's. Some briefs also stop at a summary without anything the clinic could use. If your service raised a different question, send what happened and what the team was unsure of; we would narrow the question, read for the answer, compare the study population with your patients and end on something usable. If the reading contradicts what your service does, the brief would say so plainly. If the attending asked the question, the brief would end with a line the clinic could adopt.
Get a PA-626 Week 7 example written to your instructions
Send the brief instructions with the page limit, the citation style and the topic you were given, and a custom PA-626 Week 7 directed reading brief is written to them inside 24-48h, the first one free. Add a line on the patient or moment it came from and the opening paragraph writes itself around yours.
More PA 626 papers and MPAS samples
- PA 626 Week 1: Elective Gap Post
- PA 626 Week 2: Elective Rationale Memo
- PA 626 Week 3: Self-Set Objectives Draft
- PA 626 Week 4: Specialty Vocabulary Brief
- PA 626 Week 5: Subspecialty Return Visit Note
- PA 626 Week 6: Consult Question Brief
- PA 626 Week 8: Unmet Objective Memo
- PA 624 Week 7: Local Option Inventory
- PA 648 Week 7: Attestation Packet
- PA 622 Week 7: Shared Record Memo
- PA 650 Week 7: Bedside Recommendation Statement
PA 626 Week 7 questions, answered
Nobody handed me a topic. Can I pick one?
Sections differ and many allow it, with the same requirement attached: the piece still has to say why this topic and why now. A question the writer could not answer in clinic works as well as one somebody assigned, provided the moment is named. Send the instructions and the sample opens on whichever origin applies to you, with the rest of the shape unchanged.
How many sources does a brief like this carry?
Fewer than writers expect. A short piece settling one question usually runs on a handful, and rubrics tend to mark whether each one was needed rather than how many were found. Two sources used visibly beat six listed and never referred to. Send your rubric rows and the example is built to whatever count yours names, with each source doing identifiable work in the text.
Can the brief disagree with what the service does?
It can observe a difference, which is not the same thing. The finished example reports where practice on the rotation sits beside what the sources say, gives the plausible reasons a service might be there, and leaves the judgment open. A piece announcing the service is wrong has answered a question the assignment did not set and reads badly to the person who set the topic.
Where can I find a free PA 626 Week 7 sample paper?
This page carries a complete PA 626 Week 7 directed reading brief on SGLT2 inhibitors at an eGFR of 20 to 30.
What usable product does the PA 626 Week 7 sample end on?
A template line, start or continue an SGLT2 inhibitor at eGFR 20 or above and continue below 20 if tolerated and not on dialysis, added to the clinic's reference sheet.