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Abstract: SA-PO242

Prevalence of CKD Anemia in Non-Dialysis-Dependent Patients Using Linked US Claims and Electronic Health Record Data

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical

Authors

  • Wittbrodt, Eric T., AstraZeneca, Gaithersburg, Maryland, United States
  • James, Glen, AstraZeneca, Gaithersburg, Maryland, United States
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • van Haalen, Heleen, AstraZeneca, Gaithersburg, Maryland, United States
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Sloand, James A., AstraZeneca, Gaithersburg, Maryland, United States
Background

Novel strategies for the management of anemia, a complication of chronic kidney disease (CKD), are in development. Insights into CKD-related anemia burden, associated outcomes, and resource utilization are needed from representative non-dialysis dependent CKD populations receiving high-quality clinical care. The primary study objective was to describe baseline patient characteristics, comorbidities, and anemia prevalence in non-dialysis-dependent (NDD) CKD patients in US real-world practice.

Methods

This retrospective observational study evaluated the integrated Limited Claims and Electronic Health Record Data (IBM Health, Armonk, NY). The study cohort included patients aged >18 years with >2 eGFR measures <60 mL/min/1.73 m2 at least 90 days apart. Anemia was defined as the first observed hemoglobin (Hb) <10 g/dl. The baseline period was defined as the date of the second confirmatory eGFR +6 months. Baseline anemia prevalence, demographics, comorbidities, laboratory measures, and selected medications were extracted and analyzed for the period from January 1, 2012 and September 30, 2017. Descriptive data were summarized, and no inferential statistics were performed.

Results

The study cohort (N = 33,088) was 57% female and mean (+SD) age was 70 (+13) years. The proportion of patients across CKD stages at baseline was: 3a (56%), 3b (23%), 4 (8%), and 5 (15%). Baseline comorbidities included type 2 diabetes mellitus (31%), cardiovascular disease (49%), heart failure (23%), and hyperlipidemia (62%). Median baseline (interquartile range) Hb was 12.4 (11, 13.6) g/dl, creatinine 1.3 (1.1, 1.7) mg/dl, ferritin 116 (53, 244) ng/ml, and total iron binding capacity 303 (254, 349). Baseline anemia prevalence was 30% (N = 9909/33,088). Erythropoiesis-stimulating agents (ESAs) were prescribed in 0.6% of all patients at baseline, and usage increased by worsening Hb strata (0.1% in Hb >12, 1.0% in Hb 10-11.9, 2.3% in Hb 8-9.9, and 2.6% in Hb <8 g/dl).

Conclusion

Anemia is a frequently observed complication of CKD in NDD patients and co-exists with other comorbidities. Baseline utilization of ESAs was very rare, and slightly increased use was associated with decreasing Hb in a large US cohort of NDD patients with anemia.

Funding

  • Commercial Support – AstraZeneca