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Kidney Week

Abstract: SA-PO485

Major Adverse Kidney Disease Events in a Real-World Population with Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Tuttle, Katherine R., Providence Health and Services, Spokane, Washington, United States
  • Kornowske, Lindsey M., Providence Health and Services, Spokane, Washington, United States
  • Jones, Cami R., Providence Health and Services, Spokane, Washington, United States
  • Daratha, Kenn B., Providence Health and Services, Spokane, Washington, United States
  • Koyama, Alain K., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Xu, Fang, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Miyamoto, Yoshihisa, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Neumiller, Joshua J., Washington State University, Pullman, Washington, United States
  • Alicic, Radica Z., Providence Health and Services, Spokane, Washington, United States
  • Duru, Obidiugwu, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Group or Team Name

  • CURE-CKD Registry.
Background

Assessing risk for major adverse kidney disease events (MAKDE) helps target populations who could benefit from improved chronic kidney disease (CKD) awareness, detection, and intervention. In a real-world population with diabetes, we evaluated the frequency of MAKDE and Kidney Disease Improving Global Outcomes (KDIGO) risk categories during 2013-2020.

Methods

The study population was derived from electronic health records data in the Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry at Providence and UCLA Health systems. Demographic and clinical characteristics were obtained for patients aged ≥18 years with diabetes. CKD was defined by eGFR <60 mL/min/1.73 m2, UACR ≥30 mg/g or UPCR ≥0.15 g/g. MAKDE was defined as a composite of 40% eGFR decline from baseline, eGFR <15 mL/min/1.73 m2, dialysis, or kidney transplant. Frequency of MAKDE was evaluated by baseline CKD status and KDIGO risk categories.

Results

Among patients with diabetes (N=285,036), 51% (n=144,016) were women and mean age was 61±16 years. At baseline, 21% (n=60,672) had CKD with mean eGFR of 56±24 mL/min/1.73 m2 and median UACR of 58 (interquartile range [IQR] 33-164) mg/g. Frequency of MAKDE was 27% (16,180/60,672) in those with CKD and 14% (32,112/224,364) in those without CKD. Median follow-up was 2.3 (IQR 1.0-4.0) years. Among patients with CKD who had baseline eGFR and UACR/UPCR measurements, 37% were classified as high or very high KDIGO risk. MAKDE frequency increased by higher KDIGO risk categories (Figure).

Conclusion

MAKDE occurred commonly in a real-world population with diabetes. Compared to those without CKD, prevalence of MAKDE was twice as high in patients with CKD and more than one-third of them were in high or very high KDIGO risk categories when both eGFR and UACR/UPCR were measured.

Funding

  • Other U.S. Government Support