Kidney Week

Abstract: SA-PO400

Current Nephrology Practices for Slowing CKD Progression – The Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps)

Session Information

• CKD: Risk Factors for Incidence and Progression - III
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 301 CKD: Risk Factors for Incidence and Progression

Authors

• Stengel, Benedicte, Inserm-CESP, Villejuif, France

Benedicte Stengel,

• Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Charlotte Tu,

• Lange, Celine, Biomedicine Agency, La Plaine Saint-Denis, France

Celine Lange,

• Zepel, Lindsay, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Lindsay Zepel,

• Fliser, Danilo, Saarland University Medical Centre, Homburg/Saar, Germany

Danilo Fliser,

• Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, Paraná, Brazil

Roberto Pecoits-Filho,

• Massy, Ziad, Ambroise Pare University Hospital, Boulogne Billancourt/ Paris cedex, France

Ziad Massy,

• Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Bruce M. Robinson,

Group or Team Name

• CKD-REIN and CKDopps

Background

The 2012 KDIGO guideline for the management of CKD recommends several measures for preventing CKD progression, including blood pressure (BP) control, use of renin-angiotensin system inhibitors (RASi), and dietary advice. Whether these recommendations are followed in current nephrology practice is unknown.

Methods

We used baseline data from CKDopps (2013-17), a prospective cohort study of adult patients (pts) with eGFR < 60 ml/min/1.73m² from national samples of nephrology clinics in Brazil (BR), France (FR), Germany (GER), and the United States (US) to describe success rates in achieving recommended measures by albuminuria category (using either spot or 24-hour urinary albumin or protein equivalent) or eGFR, and by country

Results

Median age ranged from 67 yrs in BR to 77 yrs in GE. Albuminuria or proteinuria was routinely measured in 42%, 44%, 43% of pts in BR, GER, and the US, respectively, and 89% in FR (where this was requested per study protocol). Proteinuria was more commonly measured than albuminuria in all countries. Percentages of pts with BP <140/90 were lower at higher UAP, and higher in the US and GER than in BR and FR. RASi use did not vary by albuminuria level, but was lower at lower eGFR in BR, GER, and the US. Receiving dietary advices was slightly more common in pts with low eGFR, and better for salt than protein intake, but dietician visit was not common practice.

Conclusion

Monitoring albuminuria as recommended is not a standard practice in nephrology. BP control and RASi use vary substantially by country, and expert dietary advice remains poor across participating countries. The effects on clinical outcomes, and reported variation in incidence of kidney failure by country, will be evaluated during follow-up.

Funding

• Commercial Support – CKDopps Brazil supported by AbbVie, CKDopps US by Keryx, and CKD-REIN by Amgen, Baxter, GSK, Fresenius, Lilly, MSD, Otsuka