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Kidney Week

Abstract: FR-PO894

Results from GUIDAGE-CKD: Guideline-Compliant Care of Patients Aged 70+ with CKD

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Ebert, Natalie, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Fietz, Anne-Katrin, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Freitag, Julia, AOK Nordost - Die Gesundheitskasse, Berlin, Germany
  • Pöhlmann, Anna, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Mielke, Nina, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Bothe, Tim, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
Background

Currently, few data exist on guideline-based care for older patients with CKD. The GUIDAGE-CKD project develops quality indicators (QI) for outpatient care of pts 70+ years with CKD and tests them in Berlin Initiative Study (BIS) and claims data. We investigate trends over time after introduction of KDIGO guidelines in 2012.

Methods

Using a Delphi process, a set of 7 QIs was consented for use in claims data (Module 1). QIs were validated in BIS data with comprehensive claims data (Module 2). Prevalences of QIs were described in age- and sex-stratified random samples in claims data (n=62,200 indiv. 70+) for the years 2012, 2014, 2016, and 2018 and standardized to the German 70+ population. Trends over time were examined with Cochran-Armitage trend test (Module 3). Initial results using claims data were reported for 5 QIs.

Results

Prevalence of CKD increased from 17.9% (95% confidence interval [CI] 15.0–21.4) in 2012 to 25.9% (CI 22.3–30.0) in 2018 (Table). Incidence of CKD increased from 6.3% (CI 4.5–8.8) in 2012 to 7.5% (CI 5.5–10.5) in 2018. The proportion of incident CKD cases with urinary albumin creatinine ratio (ACR) measurement (QI 8) increased from 10.9% (CI 10.0–12.0) in 2012 to 12.6% (CI 11.5–13.7) in 2018. The proportion of confirmed CKD G4-5 caseswith perscribed NSAIDs (QI 12, contraindicated) decreased from 3.8% (CI 2.9–4.9) in 2012 to 2.3% (CI 1.8–3.0) in 2018. The proportion of cases with CKD receiving combined prescriptions of ACE inhibitors (ACEi) and ARBs (angiotensin II receptor blockers) (QI 23, contraindicated) decreased from 3.0% (CI 2.6–3.3) in 2012 to 0.6% (CI 0.5–0.7) in 2018.

Conclusion

From 2012-2018, the prevalence and incidence of CKD increased constantly, while the proportion of contraindicated NSAID medications in stage 4-5 CKD and combined prescriptions of ACEi and ARBs decreased. These trends suggest improvements in CKD diagnosis, guideline adherence, and quality of care.