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Abstract: TH-PO1048

Statin Use Remains Suboptimal Among US Veterans with Stage 3-5 Non-Dialysis Dependent CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Markossian, Talar, Loyola University Chicago, Maywood, Illinois, United States
  • Stroupe, Kevin, Hines VA Medical Center, Hines, Illinois, United States
  • Burge, Nick, Hines VA Medical Center, Hines, Illinois, United States
  • Leehey, David J., Hines VA Medical Center, Hines, Illinois, United States
  • Pacold, Ivan M., Hines VA Medical Center, Hines, Illinois, United States
  • Kramer, Holly J., Loyola University Chicago, Maywood, Illinois, United States
Background

Statin use is one of the few interventions demonstrated in clinical trials to reduce cardiovascular disease (CVD) in adults with non-dialysis dependent chronic kidney disease (CKD-ND). KDIGO guidelines published in 2013 recommend statin use for adults age ≧50 years with CKD-ND. We previously reported suboptimal statin use during calendar year 2012 in U.S. Veterans with stage 3-5 CKD-ND with only 62.1% using statins overall and only 21.8% of Veterans with CKD-ND in absence of diabetes, clinical CVD or hyperlipidemia using statins. In this study, we reexamined statin use during calendar year 2015 among U.S. Veterans age ≧50 years with stage 3-5 CKD-ND.

Methods

We used data from the VA Corporate Data Warehouse which includes demographics, inpatient and outpatient encounter diagnosis and procedure codes [International Classification of Diseases, Ninth/Tenth Revision, Clinical Modification (ICD9/10-CM) and Current Procedural Terminology codes], outpatient pharmacy prescriptions reported by Veterans, and patient labs. Information on medications dispensed within the VA system was obtained from the Managerial Cost Accounting National Data Extracts which contains medications names and supply durations. Data were linked with the Medicare files to capture health care use and medications dispensed from non-VA pharmacies. CKD status was based on presence of at least two estimated glomerular filtration rate (eGFR) values < 60 ml/min/1.73 m2 in outpatient laboratory data spaced 90+ days apart. Co-morbidities were defined by ICD9/10 codes.

Results

There were 242,865 Veterans age ≧50 years with at least two eGFR values <60 ml/min/1.73 m2 spaced 90+ days apart during calendar year 2014 with no history of dialysis or transplantation. Mean age was 76.4 years (standard deviation 9.6) and 96.7% were male and most were white with 14.9% reporting black race. During calendar year 2015, 68.7% of these Veterans with stage 3-5 CKD-ND were using statins. Among Veterans with CKD-ND accompanied by diabetes or CVD, statin use was 75.1%. In contrast, only 36.6% of Veterans with CKD-ND in absence of diabetes, CVD or hyperlipidemia were using statins.

Conclusion

Statin use appears to have increased among Veterans with stage 3-5 CKD-ND but use still remains suboptimal, especially among those CKD-ND in the absence of diabetes or clinical CVD.

Funding

  • Veterans Affairs Support