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Abstract: TH-PO1004

Undiagnosed Early CKD in Patients with Hypertension and Cardiovascular Disease in the United States

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Kushner, Pamela R., University of California Irvine, Irvine, California, United States
  • Barone, Salvatore, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States
  • Arnold, Matthew, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
  • Chen, Hungta (tony), BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States
  • Alvarez, Christian S., BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States
Background

Chronic kidney disease (CKD) is a growing public health issue and widely under-recognized in the United States. Hypertension (HTN) and cardiovascular diseases (CVD) are well-known risk factors for CKD; and KDIGO recommends screening in both high-risk groups. Early diagnosis of CKD and active management can slow disease progression and improve outcomes, but the prevalence of undiagnosed early-stage CKD in patients with comorbidities other than type 2 diabetes (T2D) has not been reported. This analysis assessed the prevalence of undiagnosed stage 3 CKD in patients with HTN and CVD in the absence of T2D.

Methods

Data were extracted from the US TriNetX database. Patients were aged ≥18 years with 2 consecutive estimated glomerular filtration rate (eGFR) results ≥30 and <60mL/min/1.73m2 recorded 91-730 days apart between 2015 and 2020. Undiagnosed CKD was defined as the absence of a CKD diagnosis code any time before and up to 6 months after the second eGFR (index date). The analysis cohorts included patients with the following at or before index: 1) HTN ICD 9/10 diagnosis code but not for T2D; 2) HTN or atherosclerotic cardiovascular disease (ASCVD) ICD 9/10 diagnosis code but not for T2D; 3) HTN or heart failure (HF) ICD 9/10 diagnosis code but not for T2D; and 4) ICD 9/10 diagnosis code for T2D.

Results

In the absence of T2D, the proportion of undiagnosed stage 3 CKD in patients with HTN was 68.4% (95%CI: 68.2%, 68.7%). Similar proportions were observed in patients with either HTN or ASCVD (68.7%, 95%CI: 68.4%, 69.0%), and with HTN or HF (68.6%, 95%CI: 68.3%, 68.8%). These proportions were greater than those with undiagnosed stage 3 CKD and T2D (51.7%, 95%CI: 51.3%, 52.0%) (Figure).

Conclusion

A high prevalence of undiagnosed CKD in patients with existing HTN and CVD in the absence of T2D was observed in a large contemporary US database. These results highlight an opportunity to increase early identification of CKD in people with high-risk comorbidities other than T2D in order to implement targeted evidence-based therapies to slow progression of CKD and improve patient outcomes.

Funding

  • Commercial Support – AstraZeneca