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Kidney Week

Abstract: FR-PO294

CKD in Patients with Pre-Diabetes from Two Large Healthcare Systems

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Alicic, Radica Z., Providence Medical Research Center, Spokane, Washington, United States
  • Duru, Obidiugwu, David Geffen School of Medicine, Los Angeles, California, United States
  • Daratha, Kenn B., Providence Health Care, Spokane, Washington, United States
  • Jones, Cami R., Providence St. Joseph Health, Spokane, Washington, United States
  • Hennessey, Kelly Anne, University of Washington School of Medicine, Spokane, Washington, United States
  • McPherson, Sterling, Washington State University College of Medicine, Spokane, Washington, United States
  • Nicholas, Susanne B., UCLA Medical Center, Los Angeles, California, United States
  • Norris, Keith C., UCLA, Marina Del Rey, California, United States
  • Tuttle, Katherine R., University of Washington School of Medicine, Spokane, Washington, United States
Background

Chronic kidney disease (CKD) in pre-diabetes (PDM) is not well-characterized. The study aim was to determine CKD prevalence and risk factors of patients with PDM treated at two large healthcare systems in the western United States.

Methods

The Center for Kidney Disease Research, Education and Hope (CURE-CKD) registry was created from clinical and administrative data in electronic health records of Providence St. Joseph Health and University of California Los Angeles Health (years 2006-2017). PDM, CKD, and hypertension (HTN) were identified by diagnostic codes and condition-specific criteria: PDM by HbA1c 5.7-6.4% or two measures of fasting (100-125 mg/dL) or random (140-199 mg/dL) blood glucose at least one day apart; CKD by two measures of serum creatinine-based estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 (CKD-EPI), urine albumin-to-creatinine ratio ≥30 mg/g, or protein-to-creatinine ratio >150 mg/g at least 90 days apart; HTN by blood pressure ≥140/90mmHg on two measures at least 14 days apart.

Results

CKD was present in 20% of patients with PDM (101,868/497,233).Patients with CKD and PDM were predominately white (71%), women (58%), and older compared to those without CKD (72±15 years versus 56±17 years, p<0.001). HTN occurred in 72% of patients with CKD and PDM (73,788/101,868) with mean blood pressure of 131±17/70±10 mmHg. HbA1c was similar in those with and without CKD (5.8±0.3% and 5.8±0.4%). eGFR was 53±18 mL/min/1.73m2 in patients with CKD and PDM versus 89±20 mL/min/1.73m2 (p<0.001) in those without CKD. Among patients with PDM and CKD, individuals with HTN had higher eGFR compared to those without HTN (55±18 versus 50±21 mL/min/1.73m2, p<0.001) and fewer had CKD stages 4-5 (7% versus 13%, p<0.001). Among small number of patients tested, albuminuria >30 mg/g or proteinuria >150 g/g occurred in 24% (3,027/12,470) and 42%(2,519/6,026), respectively.

Conclusion

CKD and major risk factors of HTN and albuminuria/proteinuria are often present in PDM without overt diabetes. In patients with PDM, CKD assessment and risk factor management are warranted

Funding

  • Private Foundation Support