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Kidney Week

Abstract: PO0516

Epidemiology of Patients with High-Risk CKD: A Demographic Evaluation of Patients Who Had Indications for SGLT2 Inhibitors and GLP-1

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Chen, Huiwen, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Weltman, Melanie R., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Cai, Manqi, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Yabes, Jonathan, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Nolin, Thomas D., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Jhamb, Manisha, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Abdel-Kader, Khaled, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

The emerging evidence of the favorable effects of sodium-glucose co-transporter-2 inhibitors (SGLT2is) and glucagan-like peptide 1 receptor agonists (GLP-1)on renal function has brought hope and excitement to the nephrology communities in the US. However, many patients with high risk CKD and indications for SGLT2is and GLP-1 were not on the medication. We would like to identify the features of these patients and their primary care providers to offer targeted recommendations regarding concerns for initiating SGLT2is and GLP-1.

Methods

This is a preliminary analysis of data obtained from the Kidney Coordinated Health Management Partnership (K-CHAMP) study (NCT03832595), an ongoing, NIH funded pragmatic randomized control trial testing an electronic health record-based population health management approach to improve CKD care. The studied population included patients between ages 18 and 85 with either chronic kidney disease stage IV and above or features of high-risk progression based on CKD risk progression score calculated by the kidney failure risk equation. Patients were screened based on their risk score calculated by Epic EMR and arranged based on their upcoming PCP’s appointments. Patients who were taking SGLT2is or GLP-1 were compared with patients who had the indications for either medication but were not on the medications.

Results

Baseline demographics such as median age, gender, race, and BMI were compared. Comorbidities, the presence of endocrinology referral, laboratory values and whether or not patients have been on angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) were also compared. Clinicians’ characteristics were compared as well. Patients who had the indications for SGLT2is but were not on them were more likely to be older in age, had low GFR (around low 30 ml/min) and low hemoglobin A1C. Patients who had the indications for GLP-1 but not on them were likely to have high A1C and likely to have already been on insulin.

Conclusion

Identification of features of high risk patients who had clinical indications for SGLT2i and GLP-1 but were not on the medication would be helpful in finding better ways to provide nephrology recommendations regarding SGLT2is and GLP-1.

Funding

  • NIDDK Support