Abstract: SA-PO893
The Prevalence of Subtypes of Substance Use Disorder in Patients with Advanced Kidney 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
- Roche, Meaghan Sarah, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
- Cohen, Jordana B., University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
- Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background
Previous studies have shown that illicit drug use in patients on hemodialysis is associated with poor outcomes. The prevalence and characteristics of different types of substance use disorder (SUD) have not been well-described in patients with advanced chronic kidney disease (CKD).
Methods
Diagnostic codes were used to characterize the prevalence of different types of SUD in a national cohort of veterans with incident stage 4 CKD from 2003 to 2014. Subtypes of SUD were grouped as alcohol, opioid, cocaine, or polysubstance use disorders. Their clinical and demographic characteristics were compared to those among veterans without SUD using multinomial logistic regression.
Results
Among 57,874 veterans with incident stage 4 CKD, the prevalence of alcohol use disorder was 7.0%, opioid use disorder 0.4%, cocaine use disorder 0.6%, and polysubstance use disorder 4%. See Figure for adjusted relative differences in demographic and clinical characteristics by subtype of SUD (with no SUD as the reference group). The prevalence of non-Hispanic black race and Hispanic ethnicity were higher with cocaine (aOR 10.38, 95% CI 7.51-14.35 and aOR 3.21, 95% CI 1.89-5.46, respectively) and polysubstance (aOR 2.78, 95% CI 2.48-3.10 and aOR 1.56, 95% CI 1.30-1.89, respectively) use disorders.
Conclusion
Demographic and clinical characteristics vary significantly across different subtypes of SUD in veterans with stage 4 CKD. Future research is needed to evaluate the differential association of these SUD subtypes with CKD progression and mortality.
Baseline Characteristics, Grouped by SUD Subtype, Among Veterans with Stage 4 CKD