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Kidney Week

Abstract: PO0510

Spatial Distribution of Newly Detected CKD Among US Veterans, 2009-2018

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Bragg-Gresham, Jennifer L., University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Zhang, Xiaosong, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Steffick, Diane, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Weitzel, William, Veterans Health Administration, Ann Arbor, Michigan, United States
  • Crowley, Susan T., Veterans Health Administration, West Haven, Connecticut, United States
  • Saran, Rajiv, University of Michigan Medical School, Ann Arbor, Michigan, United States
Background

While the rate of new end stage renal disease (ESRD) cases has slowed in recent years, less is known about trends in the incidence of pre-ESRD CKD. Using national data from the Veterans Health Administration (VHA) we examined the rates and spatial distribution of newly detected cases of CKD using laboratory measures.

Methods

Using data from 8.5+ million US Veterans over a decade (2009-18), in the VHA system during the previous 3 years with no indication of kidney disease, rates of newly detected kidney disease were calculated by year. Three measures of kidney disease were assessed by laboratory reports; 1) eGFR < 60 ml/min/1.73m2, 2) albuminuria, and 3) either low eGFR or albuminuria. Spatial maps contain 3-year incidence rates (2016-18) by county, based on patient residence.

Results

Rates of newly detected low eGFR were steady from 2011 forward (~30/1,000 PY), after a drop from 55 to 31 cases between 2009 and 2011, a time when standardization of creatinine calibration to IDMS became mandatory and may explain the change in rates. Rates of newly detected albuminuria showed little variability (~10/1,000 PY). Areas of high incidence of low eGFR were present in northern Michigan, northern Indiana, central Illinois, and western North Carolina. Newly detected albuminuria was highest in coastal North Carolina, northern Idaho, northeastern Indiana, and on the border of Washington and Oregon.

Conclusion

Rates of newly detected disease reflect a combination of the true incidence rate as it presents to a health system, but is also influenced by the rate of testing for the disease in question. Despite this limitation, these findings are important for both individual and population health management, early detection, management and prevention.

Funding

  • Veterans Affairs Support