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Kidney Week

Abstract: PO0503

Treatment Pathways of Patients with CKD: A Report from the DISCOVER CKD Retrospective Cohort

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • James, Glen, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom
  • Carrero, Juan Jesus, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • Fishbane, Steven, Northwell, Manhasset, New York, United States
  • Moreno Quinn, Carol Patricia, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom
  • L Heerspink, Hiddo Jan, University of Groningen, Groningen, Netherlands
  • Wittbrodt, Eric T., AstraZeneca, Gaithersburg, Maryland, United States
  • Kanda, Eiichiro, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Hedman, Katarina, AstraZeneca, Gothenburg, Sweden
  • Kashihara, Naoki, Kawasaki Medical School, Kurashiki, Okayama, Japan
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Kosiborod, Mikhail, Saint Luke's Hospital of Kansas City Health Sciences Library, Kansas City, Missouri, United States
  • Carolyn, Lam Su ping, National Heart Centre Singapore, Singapore, Singapore
  • Pollock, Carol A., University of Sydney, Sydney, New South Wales, Australia
  • Stenvinkel, Peter, Karolinska Universitetssjukhuset, Stockholm, Sweden
  • Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Wheeler, David C., University College London, London, London, United Kingdom
Background

Chronic kidney disease (CKD) is a global health problem associated with clinical complications. Gaps exist in real-world data to understand treatment pathways of CKD patients. We describe treatment pathways of key medications prescribed to CKD patients in DISCOVER CKD.

Methods

The DISCOVER CKD retrospective cohort of patients were extracted using Japan Medical Data Vision (JMDV) and integrated Limited Claims and EHR (LCED) data. The study included patients aged ≥18 years with a diagnostic CKD code (stage 3A through end stage renal disease or renal replacement therapy) or 2 estimate glomerular filtration rate (eGFR) measures <75 mL/min/1.73m2 at least 90 days apart between January 2008 and October 2018. The index date was the date of first diagnostic code or 2nd eGFR. Sankey Plots were used to visualize chronological treatment pathways (1st to 3rd line) post-index of key treatments (including combinations) commonly prescribed to at least 500 CKD patients including: RAASi, statins, diuretics and anti-hypertensives. We also describe median time to first line therapy initiation.

Results

Preliminarily, in the study cohort (N=159849) anti-hypertensives were the most common first-line therapy prescribed. Median time to first-line therapy initiation for LCED and JMDV was: 48 days and 168 days for anti-hypertensives, 39 days and 89 days for diuretics, 51 days and 259 days for RAASi and 56 days and 133 days for statins, respectively. In both databases patients remained on anti-hypertensives the most (33.7%) during follow-up.

Conclusion

Patients with CKD have high therapy burden, with varying time to initiation of therapies.