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Abstract: PO0278

Clinical Outcomes in Patients with Anemia in CKD Using Linked US Claims and Electronic Health Records

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Wittbrodt, Eric T., AstraZeneca, Wilmington, Delaware, United States
  • James, Glen, AstraZeneca, Cambridge, United Kingdom
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • Garcia Sanchez, Juan Jose, AstraZeneca, Cambridge, United Kingdom
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Sloand, James A., AstraZeneca, Gaithersburg, Maryland, United States
  • Kalantar-Zadeh, Kamyar, University of California - Irvine, Irvine, California, United States
Background

Anemia is common in pts with CKD, yet contemporary outcome data to understand the long-term clinical burden are scarce. This analysis describes selected cardiovascular and renal outcomes in non-dialysis CKD pts with and without anemia at baseline (BL) in US real-world practice.

Methods

This retrospective observational study evaluated the integrated Limited Claims and Electronic Health Record data (IBM Health, Armonk, NY). Pts were aged ≥18 y with ≥2 eGFR measures <60 mL/min/1.73 m2 ≥90 days apart. Anemia was defined as the presence of any observed Hb <10 g/dL within ± 6 months of confirmatory eGFR (anemia BL period). In addition, the BL period for disease history was defined as the start of pt data + 6 months, and for lab measures and medications was defined as date of the second confirmatory eGFR + 6 months. Pts with active bleeding, chronic dialysis, and iron deficiency anemia were excluded. BL pt characteristics and clinical outcomes during follow-up were analyzed for the period from Jan 1, 2012 to Sep 30, 2017. Descriptive data were summarized; no inferential statistics were performed.

Results

Of the total study cohort (N=22,720), 23% (n=5283) had BL Hb <10 g/dL. The following results are for pts with and without anemia at BL, respectively. Females accounted for 60% and 57% and mean ages (± SD) were 70 (14) and 71 (12) y. Proportions by BL CKD stage were: 3a, 50% and 68%; 3b, 27% and 24%; 4, 15% and 7%; 5, 9% and 1%. Median follow-up times were 2.9 and 3.8 y. Acute coronary syndrome (ACS) events during follow-up occurred in 2.2% of pts with BL anemia and 2.3% of pts without BL anemia, heart failure hospitalizations (hHF) occurred in 5.9% and 3.7%, and stroke hospitalizations and emergency visits (S) occurred in 2.8% and 3.0% of pts. Incidence rates rates/100 pt-y were 0.8 and 0.7 for ACS, 1.6 and 0.8 for hHF, respectively, and 0.7 in both groups for S. ESRD occurred in 4% and 1%, 40% eGFR decrease in 44% and 25%, and CKD stage progression in 67% and 59% of pts. Median change in eGFR slope was –0.6 and –0.3 mL/min/1.73 m2.

Conclusion

This analysis highlights worsened outcomes associated with anemia in CKD, particularly hHF and eGFR decline, in pts of a large US cohort.

Funding

  • Commercial Support –