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Kidney Week

Abstract: PO0502

Treatment Pathways of CKD Patients Defined by the 2012 KDIGO CKD Classification: A Report from the DISCOVER CKD Retrospective Cohort

Session Information

Category: CKD (Non-Dialysis)

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


  • Garcia Sanchez, Juan Jose, AstraZeneca, Cambridge, United Kingdom
  • Carrero, Juan Jesus, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • 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
  • L Heerspink, Hiddo Jan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands
  • Nolan, Stephen, 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
  • Abdul Sultan, Alyshah, AstraZeneca, Cambridge, United Kingdom
  • Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan
  • Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States
  • Wheeler, David C., University College London, London, London, United Kingdom
  • Pollock, Carol A., Royal North Shore Hospital, St Leonards, New South Wales, Australia

Treatment strategies to delay the progression of CKD focus on use of RAASi, anti-hypertensive and, for patients with type 2 diabetes, anti-diabetic therapy. Data describing treatment pathways in patients defined according to the 2012 KDIGO classification are scarce.


The DISCOVER CKD retrospective cohort of patients was extracted using the integrated Limited Claims and EHR data. Patients were aged ≥18 years, with ≥1 UACR measure and two measures of eGFR 0-75 mL/min/1.73 m2 recorded at least 90 days apart between 2008-2018. Sankey Plots were used to visualize chronological treatment pathways (1st-3rd line) post-index, of key treatments commonly prescribed to these CKD patients including: RAASi, anti-diabetic therapy, beta-blockers and anticoagulants. We also describe median time to 1st line therapy initiation.


Preliminarily, 4283 patients were prescribed key treatments during follow-up with anti-hyperglycaemic therapy and RAASi therapy being the most common 1st-line therapy, Figure 1. Median time to 1st-line therapy initiation was: 34 days for anti-diabetic therapy, 45 days for beta-blockers, 49 days for RAASi therapy and 50 days for anticoagulants. Anti-diabetic therapy and RAASi therapy accounted for the highest proportion of time in which treated patients remained on therapy during follow-up (68% and 61%, respectively).


We observed a high proportion of time on therapy for key pharmacological treatments during the follow-up period. However, it is well established that a substantial residual risk and unmet need exists with current standard of care.


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