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

• CKD Health Services Research
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Garcia Sanchez, Juan Jose, AstraZeneca, Cambridge, United Kingdom

Juan Jose Garcia Sanchez,

• Carrero, Juan Jesus, Karolinska Institutet, Stockholm, Stockholm, Sweden

Juan Jesus Carrero,

• Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States

Supriya R. Kumar,

• Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Roberto Pecoits-Filho,

• James, Glen, AstraZeneca, Cambridge, United Kingdom

Glen James,

• L Heerspink, Hiddo Jan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Hiddo Jan L Heerspink,

• Nolan, Stephen, AstraZeneca, Cambridge, United Kingdom

Stephen Nolan,

• Carolyn, Lam Su ping, National Heart Centre Singapore, Singapore, Singapore

Lam Su ping Carolyn,

• Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States

Hungta (tony) Chen,

• Kanda, Eiichiro, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan

Eiichiro Kanda,

• Abdul Sultan, Alyshah, AstraZeneca, Cambridge, United Kingdom

Alyshah Abdul Sultan,

• Kashihara, Naoki, Kawasaki Ika Daigaku, Kurashiki, Okayama, Japan

Naoki Kashihara,

• Kosiborod, Mikhail, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, United States

Mikhail Kosiborod,

• Wheeler, David C., University College London, London, London, United Kingdom

David C. Wheeler,

• Pollock, Carol A., Royal North Shore Hospital, St Leonards, New South Wales, Australia

Carol A. Pollock,

Background

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.

Methods

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 (1^st-3^rd 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 1^st line therapy initiation.

Results

Preliminarily, 4283 patients were prescribed key treatments during follow-up with anti-hyperglycaemic therapy and RAASi therapy being the most common 1^st-line therapy, Figure 1. Median time to 1^st-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).

Conclusion

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.

Funding

• Commercial Support –