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Kidney Week

Abstract: PO0963

Incident CKD in Diabetes, Hypertension, and Prediabetes

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Jones, Cami R., Providence Health and Services, WA, Spokane, Washington, United States
  • Daratha, Kenn B., Providence Health and Services, WA, Spokane, Washington, United States
  • Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Alicic, Radica Z., Providence Health and Services, WA, Spokane, Washington, United States
  • Duru, Obidiugwu, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Burrows, Nilka Rios, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Tuttle, Katherine R., Providence Health and Services, WA, Spokane, Washington, United States
  • Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
Background

Hypertension (HTN), diabetes mellitus (DM), and prediabetes (PDM) are major risk factors for chronic kidney disease (CKD), yet community-level longitudinal studies of CKD incidence are lacking. The study aim was to determine CKD incidence rates in these at-risk groups by practice- and guideline-based definitions.

Methods

The Center for Kidney Disease Research, Education, and Hope (CURE-CKD) registry is curated from electronic health records with clinical and administrative data from two large non-profit healthcare systems. CKD incidence (95% CI) in adults was calculated over 4, two-year time periods during 2010-2017 adjusted for age, sex, and race/ethnicity. CKD was identified by 2 definitions: 1. Practice-based, CURE-CKD: At least 2 laboratory measures for CKD ≥90 days apart (estimated glomerular filtration rate - eGFR <60 mL/min/1.73m2, urine albumin/creatinine ratio - UACR ≥30 mg/g, or urine protein/creatinine ratio - UPCR ≥150 mg/g) or CKD administrative code; 2. Guideline-based, Kidney Disease Improving Global Outcomes (KDIGO): At least 2 eGFRs <60 mL/min/1.73m2 or 2 UACRs/UPCRs >30 mg/g/≥150 mg/g ≥90 days apart.

Results

Overall adjusted CKD incidence rates declined over 2010-2017 by both definitions with lower rates by KDIGO (Table). By CURE-CKD, CKD incidence increased in the HTN group.

Conclusion

The practice-based CURE-CKD definition produced higher estimates of CKD incidence than the stricter guideline-based KDIGO definition. CKD incidence declined in all groups, except for HTN by the CURE-CKD definition, and was highest in patients with DM/HTN. Targeting these at-risk conditions for control may mitigate new onset CKD in these groups.

Funding

  • Other U.S. Government Support