Abstract: FR-PO495

Racial Disparities in Trajectory of eGFR Decline in Patients with or at Risk for CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Nicholas, Susanne B., UCLA, Los Angeles, California, United States
  • Daratha, Kenn B., Washington State University, Spokane, Washington, United States
  • Shen, Jenny I., LaBiomed at Harbor-UCLA, Torrance, California, United States
  • Bell, Douglas S, UCLA, Los Angeles, California, United States
  • Alicic, Radica Z., Providence Medical Research Center, Spokane, Washington, United States
  • Tuttle, Katherine R., University of Washington School of Medicine, Spokane, Washington, United States
  • Norris, Keith C., UCLA, Los Angeles, California, United States

Group or Team Name

  • UCLA-PHS CKD Registry Study Team
Background

Blacks have a 3.5-fold greater prevalence of advanced chronic kidney disease (CKD) compared to non-Blacks. However, less is known about patterns of CKD progression in Blacks relative to non-Blacks in real world settings. UCLA and PHS have formed the largest combined electronic health record (EHR) based CKD and at-risk for CKD Registry. This study compares trajectories of estimated glomerular filtration rate (eGFR) between Blacks and non-Blacks in the UCLA dataset.

Methods

Data in the UCLA CKD and at-risk CKD Registry were analyzed from 176,406 patients who had at least two eGFR measurements from 2006-2016. Mean baseline eGFRs were compared using independent samples t-tests. Trajectories of eGFR of Blacks versus non-Blacks over the 11 years of the study were assessed using linear mixed models with random effects controlling for age and gender.

Results

Baseline characteristics of the overall cohort were: age 55±18 (mean±SD) years, CKD-EPI eGFR 90±24 mL/min/1.73m2, 8% Black and 55% women. Among patients with baseline eGFR ≥60mL/min/1.73m2, Blacks had higher mean baseline eGFR (103±23 versus 94±19 mL/min/1.73m2, p<0.001), and higher mean difference in eGFR (6.8 mL/min/1.73m2; 95% CI=6.6-6.9; p<0.001) than non-Blacks. Among patients with baseline eGFR 30-59 mL/min/1.73m2, mean baseline eGFR was similar for Blacks and non-Blacks (49±8 versus 50±8 mL/min/1.73m2, p=0.004). However, Blacks appear to have steeper trajectory of eGFR decline (mean difference in eGFR 1.8 mL/min/1.73m2; 95% CI=1.4-2.3; p<0.001).

Conclusion

The trajectories of eGFR differed between Blacks and non-Blacks depending on baseline eGFR ≥60 or 30-59mL/min/1.73m2, by a pattern shift from higher eGFR trajectories to lower, steeper eGFR trajectories. These data may signal critical windows for interventions to reduce disparities and improve kidney health in this high-risk group of Black patients.

Funding

  • Private Foundation Support