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Abstract: TH-PO718

Social Determinants of Health Predict Annual CKD Screening and Disease Development Among Newly Diagnosed Hypertensive and Type 2 Diabetic Patients in a Large Midwestern Health System

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Ingle, Marybeth, Advocate Health Care Inc, Downers Grove, Illinois, United States
  • Baman, Sarang, Advocate Health Care Inc, Downers Grove, Illinois, United States
  • Du, Yuxian, Bayer AG, Leverkusen, Nordrhein-Westfalen, Germany
  • Valuckaite, Vesta, Bayer AG, Leverkusen, Nordrhein-Westfalen, Germany
  • Singh, Rakesh, Bayer AG, Leverkusen, Nordrhein-Westfalen, Germany
  • Kong, Sheldon X., Bayer AG, Leverkusen, Nordrhein-Westfalen, Germany
  • Williamson, Todd E., Bayer AG, Leverkusen, Nordrhein-Westfalen, Germany
  • Khatib, Rasha, Advocate Health Care Inc, Downers Grove, Illinois, United States
Background

Clinical guidelines suggest regular chronic kidney disease (CKD) screening after diagnosis of hypertension (HTN) or type 2 diabetes (T2DM), as both are risk factors. Monitoring of kidney function allows for early detection of CKD & can improve quality of life. However, social determinants of health (SDOH) can impact access to routine care, including CKD screening. We explore how SDOH factors from electronic health records (EHR) predict CKD screening & CKD development among newly diagnosed HTN and/or T2DM patients.

Methods

EHR of patients (n=235,208) with a new HTN and/or T2DM diagnosis between 2015-2018 were abstracted. Patients were followed for 3 years to assess annual CKD screening (1 estimated glomerular filtration rate & 1 urinary albumin-to-creatine ratio) and CKD development (CKD or end stage renal disease). Multivariable logistic regression models evaluated SDOH factors with CKD screening & CKD development.

Results

Most patients were White (57%) females (55%) with HTN (65%). Few had only T2DM (9%) & 26% had both. Screening was highest for patients who developed HTN & T2DM during the study (44%) compared to T2DM (38%) or HTN (4%). CKD developed for 9% of patients. Public health insurance patients were 66% more likely to not be screened for CKD compared to patients with private insurance (Odds Ratio (OR)=1.66, 95% Confidence interval (CI):1.60,1.73). Retired patients were less likely to not be screened (OR=0.77, 95%CI:0.72,0.82). Black (OR=0.54, 95%CI:0.52,0.56), Hispanic (OR=0.55, 95%CI:0.53,0.58), & Asians (OR=0.64, 95%CI:0.60,0.68) were less likely to not be screened compared to Whites. Figure 1 depicts SDOH factors & CKD development. Blacks were over twice as likely to develop CKD (OR=2.11, 95%CI:1.95,2.29).

Conclusion

The increase in CKD incidence among Black and retired patients could be due to frequent screenings. However, employment and single status were not a predictor of screening, yet a predictor of CKD. It’s possible lifestyle factors unique to this population contribute to CKD development.

Funding

  • Commercial Support –