Kidney Week

Abstract: TH-PO736

Examining the Role of KidneyIntelX in Addressing Health Inequity in CKD

Session Information

• Diversity and Equity in Kidney Health - I
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 800 Diversity and Equity in Kidney Health

Authors

• Freedman, Barry I., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Barry I. Freedman,

• Paige, Rebekah A., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Rebekah A. Paige,

• Spainhour, Mitzie H., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Mitzie H. Spainhour,

• Bagwell, Benjamin M., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Benjamin M. Bagwell,

• Houlihan, Jennifer, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Jennifer Houlihan,

• Lord, Richard William, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States

Richard William Lord,

Background

Compared to European Americans (EAs), African Americans (AAs) have a significantly higher burden of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This finding results from biologic differences and environmental factors. Failure to identify patients with early stage CKD and the limited availability of prognostic tools predicting disease progression contribute to these health disparities.

Methods

KidneyIntelX is a novel bioprognostic™ test that combines results from blood biomarkers with electronic health record (EHR) data using a machine learning algorithm to assess near-term risk of progressive kidney function decline in patients with type 2 diabetes (T2D) and CKD. To assess the impact and effectiveness of KidneyIntelX on outcomes, 2000 patients with T2D and estimated glomerular filtration rate (eGFR) 30-59 ml/min/1.73 m² [G3a, G3b]* or eGFR ≥ 60 with urine albumin:creatinine ratio (UACR)≥ 30 mg/g [A2, A3] are being enrolled into a prospective study at Atrium Health Wake Forest Baptist/Atrium Health primary care provider (PCP) clinics in North Carolina. We examined ancestry-based differences in KidneyIntelX test results and assessed their impact on medication prescription, blood pressure control, and engagement with consult services in an attempt to optimize care and address inequities in CKD among AAs.

Results

Of the initial 185 patients recruited from 46 unique PCPs, 43% (79) self-identified as AA and 57% (106) as non-AA (predominantly EA). As observed, despite similar degrees of kidney function (median eGFR 58 vs. 53 ml/min/1.73 m² and median UACR 78 vs. 51 mg/g in AAs vs. non-AAs, respectively), the proportion of AAs scored as “high risk” by KidneyIntelX was 3.5-fold higher (18% in AA vs. 5% in non-AA). Of the 14 AA high-risk patients, 6 (43%) had adjustments in clinical care.

Conclusion

The KidneyIntelX risk score is being assessed for its ability to predict progressive decline in kidney function in patients with T2D and early-stage CKD. It is hoped results will allow PCPs and healthcare systems to optimize allocation of treatments and clinical resources to those at highest risk, beyond traditional clinical metrics. Early data suggests that AA patients exhibit higher risk levels that may trigger more timely and effective interventions at earlier stages.

Funding

• Commercial Support –