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Abstract: SA-PO930

Clinical Burden of Complications Associated with CKD: A Novel Cardio-Renal Risk Tool

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Palaka, Eirini, AstraZeneca, Cambridge, United Kingdom
  • Darlington, Oliver T., Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
  • McEwan, Philip, Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
  • Grandy, Susan, AstraZeneca, Gaithersburg, Maryland, United States
Background

The prevalence of chronic kidney disease (CKD) is growing worldwide. CKD affects approximately 15% of Americans. CKD patients are a complex and comorbid population. Complications are frequent in people with CKD and represent an important component of the associated disease burden. This study aimed to synthesize evidence reporting associations between two common complications of CKD, hyperkalemia (HK) and anemia, and risk of adverse outcomes including death and cardiovascular (CV) events in a novel risk tool to encourage a holistic approach to evaluating the associated disease burden.

Methods

Systematic literature reviews were conducted to identify studies reporting risk of either HK or anemia in people with CKD including those receiving dialysis, and studies associating the incidence of HK or anemia with clinical outcomes including mortality, hospitalization and CV events. Reported evidence was then incorporated in a Cardio-Renal Risk Awareness and Impact Tool developed in Excel to characterize the risks of HK, anemia and associated adverse outcomes in people with CKD.

Results

A total of 314 studies were identified that reported the risk of HK (n=123) or anemia (n=191), or the association between each complication and patient outcomes. For male patients aged 65 years with CKD stage 3b, the estimated 5-year risk of a HK event (potassium>5.5mmol/L) was 11.9%. Separately, the prevalence of anemia (Hb<11g/dL) was 35.0%. For a patient with HK the estimated relative risks (RR) of death, hospitalization and CV events were 1.50, 1.20 and 1.08, respectively. For a patient with anemia corresponding RRs were 1.13, 1.47 and 1.12. Furthermore, estimated RRs increased with the severity of each complication; RRs of death, hospitalization and CV events increased to 2.19, 1.73 and 1.14 for a patient with potassium>6.0mmol/L and to 1.13, 1.72 and 1.24 for a patient with Hb<10g/dL, respectively.

Conclusion

HK and anemia are both consistently and independently associated with increased risk of adverse outcomes in CKD patients. This study uniquely synthesizes the growing body of evidence on the epidemiology and impact of complications such as HK and anemia in CKD patients. This novel risk tool can be used to communicate the importance of timely diagnosis and management of these conditions to reduce the burden of disease in this population.

Funding

  • Commercial Support –