ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0436

Defining the Excess Risk of Adverse Kidney Outcomes in CKD Patients with Type 2 Diabetes in the DISCOVER-CKD Cohort

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Abdul Sultan, Alyshah, AstraZeneca, Cambridge, United Kingdom
  • Nolan, Stephen, AstraZeneca, Cambridge, United Kingdom
  • Carrero, Juan Jesus, Karolinska Institute, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Jiang, Zhuoxin, AstraZeneca, Gaithersburg, Maryland, United States
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • James, Glen, AstraZeneca, Cambridge, United Kingdom
  • Garcia Sanchez, Juan Jose, AstraZeneca, Cambridge, United Kingdom
  • Carolyn, Lam Su ping, National Heart Centre Singapore, Singapore, Singapore
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Kanda, Eiichiro, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
  • Pollock, Carol A., Royal North Shore Hospital, St Leonards, New South Wales, Australia
  • Wheeler, David C., University College London, London, London, United Kingdom
  • L Heerspink, Hiddo Jan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands
Background

Chronic Kidney Disease (CKD) patients with type 2 diabetes (T2D) are considered at a high risk of cardiovascular events. However, the excess risk of major kidney events in T2D patients compared to patients without T2D is unknown.

Methods

DISCOVER-CKD is an international observational study of patients with CKD that encompasses large retrospective electronic medical records (EMR) and claims data between 2008 and 2020. Preliminarily, data from US-based Limited Claims and Electronic Health Record (LCED) data (IBM Health, Armonk, NY) and TriNetx (hospital-based EMR) were analysed. CKD patients (eGFR <75 mL/min/1.73m2) aged ≥18 years with ≥1 record of urine albumin to creatinine ratio (UACR) were identified. T2D status was ascertained any time before the index date (2nd eGFR measurement). The risk of kidney outcomes (sustained ≥50% eGFR decline or end-stage kidney disease) was compared between patients with and without T2D at 5 years’ follow-up.

Results

Compared to non-T2D patients, T2D patients had a slightly higher incidence rate of adverse renal outcomes (LCED: 2.7% versus 2.3% per year; TriNetX: 1.8% versus 1.2% per year). After adjusting for all confounding factors (Figure 1) we observed no increased risk of adverse renal outcomes in patients with T2D compared to non-T2D patients in LCED (hazard ratio (HR): 1.08: 95%CI 0.81-1.43) and a 34% increased risk in TriNetX database (HR:1.34; 95%CI 1.11-1.62).

Conclusion

There is an excess risk of adverse renal outcomes in CKD patient with T2D compared to those without T2D.This is explained to a large extent by conventional risk markers in LCED but not completely in TriNetX. Both groups (T2D and non-T2D) should be managed proactively to reduce the risk of poor clinical outcomes.

Funding

  • Commercial Support