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Kidney Week

Abstract: PO0789

Comorbidity Burden Among Patients with CKD and Type 2 Diabetes in a US Commercially Insured/Medicare Advantage Population

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Chung, Haechung, HealthCore, Inc., Wilmington, Delaware, United States
  • Thomas, Nicole M., HealthCore, Inc., Wilmington, Delaware, United States
  • Willey, Vincent, HealthCore, Inc., Wilmington, Delaware, United States
  • Kong, Sheldon X., Bayer US, Whippany, New Jersey, United States
  • Singh, Rakesh, Bayer US, Whippany, New Jersey, United States
  • Farej, Ryan, Bayer US, Whippany, New Jersey, United States
  • Partridge, Jamie, Bayer US, Whippany, New Jersey, United States
  • Elliott, Jay, Bayer US, Whippany, New Jersey, United States
Background

While it is well-established that T2D is the leading cause of CKD, contemporary data describing the burden of CKD among patients with both T2D and CKD is scarce. We described 3 mutually exclusive patient cohorts: T2D only, CKD with T2D, CKD without T2D in the real-world setting.

Methods

This cross-sectional study utilized 3 calendar years (2017-2019) of administrative claims data from the HealthCore Integrated Research Database. Adults diagnosed with CKD with and without T2D (CKD in T2D and CKD, respectively) and T2D without CKD (T2D) in 2018 were identified. Index date was defined as the first claim with a diagnosis for either CKD or T2D in 2018. Eligible patients were required to have continuous health plan enrollment ≥1 year pre- and post-index. Clinical characteristics, comorbidity burden (as measured by the Quan-
Charlson Comorbidity Index (QCI)) and hospitalizations were analyzed descriptively.

Results

Among 203,576 T2D, 22,689 CKD and 38,587 CKD in T2D patients, mean age was 59 (SD: 12), 66 (SD: 16) and 67 (SD: 13) years; 47%, 51%, and 47% were female, respectively. Both pre- and post-index, the CKD in T2D group had the highest proportion of comorbid
conditions followed by the CKD and T2D group and overall comorbidity burden was elevated in a similar manner (QCI ≥3 in 6%, 19% and 31%, respectively). Hypertension (79-94%), dyslipidemia (68-87%) and obesity (28-44%) were the most prevalent comorbidities.
Atherosclerotic cardiovascular disease (e.g. – myocardial infarction: 6.6%, 4.2%, 2.5%; ischemic stroke/TIA: 7.9%, 6.5%, 2.9%, respectively) and heart failure (19.1%, 13.4%, 4.5%, respectively) were most prevalent in the CKD in T2D group, followed by the CKD and T2D
groups. During the year post-index, the proportion of all-cause hospitalization was 11% (T2D), 22% (CKD) and 28% (CKD in T2D).

Conclusion

CKD in T2D was associated with substantial overall and cardiovascular comorbidity burden in this contemporary real-world cohort, followed by CKD and then by T2D patients. Treatment strategies for CKD in T2D should consider the patient’s individual comorbidity burden to reduce risk of cardiovascular and overall morbidity and mortality.

Funding

  • Commercial Support