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Abstract: PO2347

Identifying Hotspots of CKD in the United States with Data from a Large National Clinical Laboratory Network

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
  • Fraunhofer, Linda, Laboratory Corporation of America, Burlington, North Carolina, United States
  • Ennis, Jennifer L., Laboratory Corporation of America, Burlington, North Carolina, United States
  • Han, Yun, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Saran, Rajiv, University of Michigan Medical School, Ann Arbor, Michigan, United States
Background

CKD is typically detected through routine laboratory testing. We sought to assess the feasibility of analyzing data from one of the largest clinical laboratory networks in the US to map CKD hotspots across the nation.

Methods

Laboratory results for serum creatinine were analyzed from a nationally standardized laboratory platform with the Laboratory Corporation of America (Labcorp) across a 6-month period (July to December 2019, n=21,884,579). We assessed the percent of results with eGFR <60 ml/min/1.73m2 (CKD stages 3-5) at US county-level (n=2,972 counties, <11 results supressed). Due to lack of race information, the CKD-Epi equation without the race coefficient was employed for the entire population. Hotspot analyses were conducted using the Getis-Ord Gi* statistic.

Results

The total population was 44% male with mean age of 56 years. eGFR results < 60 ml/min/1.73m2 totalled 4,165,540 (19%) and county-level distribution ranged from 0% to 75% (Fig. A) with an overall mean age of 72 and 44% male. Results of the hotspot analysis (Fig. B) shows the percent of decreased kidney function varies markedly across the US, with clear hot spots in the south and southeast, far northeast, Pacific Northwest, Missouri, Colorado, and Utah. The upper midwest and most of the northeast appeared as cold spots, with the southwest being neither a hot nor cold spot.

Conclusion

We demonstrate the feasibility of leveraging a large national laboratory network database for mapping the distribution of county prevalence of CKD and identification of CKD hotspots. Ongoing work is focusing on understanding factors underlying these hotspots and will help guide population health improvement, raise awareness, guide health policy and direct public health action and quality improvement efforts related to kidney disease.

Funding

  • Commercial Support –