Abstract: PO0768
Characteristics of Patients with CKD and Diabetes by Use of ACE Inhibitors or ARBs
Session Information
- Diabetic Kidney Disease: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Jones, Cami R., Providence Health Care, Spokane, Washington, United States
- Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
- Daratha, Kenn B., Providence Health Care, Spokane, Washington, United States
- Alicic, Radica Z., Providence Health Care, Spokane, Washington, United States
- Fatoba, Samuel Tolu, Bayer Pharma AG, Berlin, Berlin, Germany
- Kong, Sheldon X., Bayer Corp, Whippany, New Jersey, United States
- Elliott, Jay, Bayer Corp, Whippany, New Jersey, United States
- Tuttle, Katherine R., Providence Health Care, Spokane, Washington, United States
Group or Team Name
- CURE-CKD
Background
The Center for Kidney Disease Research, Education and Hope (CURE-CKD) registry is curated from electronic health records (EHR) of >3.4 million patients with or at-risk of chronic kidney disease (CKD) at two, large healthcare systems. The study aim was to compare demographic and clinical characteristics of patients with CKD and diabetes (DM) by use of angiotensin converting enzyme inhibitors (ACEis) or angiotensin receptor II blockers (ARBs).
Methods
Demographic and clinical characteristics of adults (≥20 years) with CKD and DM (guideline-based laboratory criteria, use of glucose-lowering agents, administrative codes) were described for the time periods of 2015-17 and 2018-20. Pearson’s chi-squared (categorical), Student’s t-test (normal, continuous), or Mann-Whitney U (non-normal, continuous) analyses determined differences between users and non-users of ACEi or ARB defined by prescriptions in the EHR.
Results
ACEis/ARBs were used in 59% and 58% of patients with CKD and DM in 2015-17 and 2018-20, respectively. Adults >60 years old, men, and White/non-LatinX individuals more commonly used ACEis/ARBs (Table). In both time periods estimated glomerular filtration rate (eGFR) was significantly lower and systolic blood pressure was significantly higher in ACEi/ARB users versus non-users. The urine albumin-to-creatinine ratio did not differ by ACEi/ARB use. SGLT2 inhibitors and GLP-1 receptor agonists were more commonly given to ACEi/ARB users but prescribing of these agents was rare overall.
Conclusion
ACEi/ARB use remains sub-optimal in patients with CKD and DM and is more common in those who are older, men, and White/non-LatinX. Use of glucose-lowering agents recommended for kidney and heart protection remains very low. Further studies are needed to elucidate reasons for under-use of recommended therapies in patients with CKD and DM.
Funding
- Commercial Support –