Abstract: SA-PO885
Statin Prescription in CKD Patients Aged ≥50 Years Without Prevalent Coronary Heart Disease
Session Information
- CKD: Pharmacoepidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Shin, Jung-Im, Johns Hopkins University, Baltimore, Maryland, United States
- Qiao, Yao (Lucy), Johns Hopkins University, Baltimore, Maryland, United States
- Inker, Lesley, Tufts Medical Center, Boston, Massachusetts, United States
- Coresh, Josef, Johns Hopkins University, Baltimore, Maryland, United States
- Chang, Alex R., Geisinger Medical Center, Danville, Pennsylvania, United States
- Grams, Morgan, Johns Hopkins University, Baltimore, Maryland, United States
Background
According to the 2013 Kidney Disease Improving Global Outcomes (KDIGO) guideline, statins are recommended in adults aged ≥50 years with chronic kidney disease (CKD) stages 3-5, not on dialysis. Our objective was to examine whether there was a change in prescription prevalence after publication of the KDIGO guideline in November 2013 in two real-world populations.
Methods
We created one-year period prevalence cohorts for each year in the Geisinger Health System (2004-2016) and Johns Hopkins Medicine (2013-2016), including patients with CKD stages 3-4 (to be conservative so as not to inadvertently include end-stage kidney disease), age ≥50 years, and without prevalent coronary heart disease (another indication for statin use that could confound interpretation).
Results
At Geisinger (N=54,788, mean age 72 years, 65% female, 99% white, mean eGFR 50 ml/min/1.73 m2), statin prescription increased from 28% to 41% from 2004 to 2007 (p<0.001), but then remained relatively stable (Figure). There was no significant change in statin prescription after the KDIGO guideline was published; prevalence of statin prescription in 2016 was 47%. At Hopkins (N=19,682, mean age 70 years, 61% female, 67% white, mean eGFR 50 ml/min/1.73 m2), statin prescription did not change after the KDIGO guideline; prevalence of prescription in 2016 was 52%.
Conclusion
Despite the 2013 KDIGO’s recommendation that all adults with CKD aged ≥50 years should be prescribed statins, nearly half of the patients were not prescribed for statin in 2016 in two real-world settings. We need to understand better why adherence to KDIGO guideline on statin use is low in this high-risk population.
Figure. Prevalence of statin prescription in CKD G3-4 patients aged ≥ 50 years without prevalent coronary heart disease
Funding
- NIDDK Support