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Kidney Week

Abstract: SA-PO320

Temporal Relationship Between Prior Estimated Glomerular Filtration Rate Testing and Dialysis Initiation in a Real-World Population of Incident Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Karpinski, Steph, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Walker, Adam G., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Colson, Carey, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Sibbel, Scott, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
Background

Properly preparing for dialysis initiation can lead to better short and long-term outcomes for new dialysis patients. These preparation activities usually require ≥6 months lead time and knowledge of the severity of a patient’s kidney disease. We sought to describe the patterns of dialysis starts with respect to timing and severity of prior estimated glomerular filtration rate (eGFR) testing.

Methods

For this analysis, we used the Optum® de-identified Integrated Dataset that links administrative claims and clinical data from providers across the continuum of care. We examined 5,900 adults who initiated dialysis across multiple outpatient provider networks between 2012 and 2019. Patients without continual insurance coverage for at least 61 days prior to dialysis start were excluded. All eGFR test results were obtained in outpatient settings prior to the start of dialysis.

Results

External data results show that 34.8% of patients who start dialysis did not have an ambulatory eGFR measured 6 months or more prior to initiation of dialysis. This includes 23.9% of subjects with no documented eGFR before starting outpatient dialysis and an additional 10.9% with less than 6 months between 1st eGFR and dialysis start. Only 55.9% of patients have had a documented eGFR less than 60 mL/min/1.73m2, 6 months or more prior to arrival at a dialysis clinic.

Conclusion

Increased surveillance of eGFR prior to dialysis start will lead to better outcomes for patients.