Kidney Week

Abstract: FR-PO0342

Testing for CKD Among Patients with Diabetes Mellitus (DM) in the US Military Health System (MHS)

Session Information

• Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Brier, Benjamin E., Walter Reed National Military Medical Center, Bethesda, Maryland, United States

Benjamin E. Brier, MD

• Oliver, James D., Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

James D. Oliver, MD, PhD

• Marneweck, Hava, Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, United States

Hava Marneweck, MS

• Banaag, Amanda, Henry M Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, Maryland, United States

Amanda Banaag, MPH

• Han, Sola, Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Sola Han, PharmD, PhD

• Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Meda E. Pavkov, MD, PhD

• Koehlmoos, Tracey L., Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States

Tracey L. Koehlmoos, PhD

• Nee, Robert, Walter Reed National Military Medical Center, Bethesda, Maryland, United States

Robert Nee, MD, FASN

Background

Annual CKD testing using both urine albumin-to-creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR) remains low (25–50%) among U.S. adults with DM. As an integrated health care system with universal coverage, we hypothesized that CKD testing rates among DM adults in the MHS would be higher than the overall national trend.

Methods

Using the MHS Data Repository (2016−2022), we analyzed the annual prevalence of nonpregnant DM adults with and without CKD based on ICD-10 codes who were tested in the outpatient setting with both eGFR and urine albumin measurements (uACR and urine albumin concentration). We conducted logistic regression analyses to assess the association of demographic factors and dual lab testing, adjusting for rank, active-duty status, and comorbidities.

Results

In 2022, 164,654 (6.5%) of 2,544,963 adults in the MHS had DM (median age 60, IQR 54−64 years; male 51.3%; White 45.1%, Black 22.3%, Asian American/Pacific Islander 8.6%, Native American/Alaska Native 0.7%, Other 8.5%; median eGFR = 81, IQR 60–98 ml/min/1.73m², median uACR = 21, IQR 9–71 mg/g). About 54% of DM+/CKD- and 55% of DM+/CKD+ were tested for both eGFR and albuminuria. During 2016–2022, dual testing in the diabetes cohort ranged from 53% to 58% (Fig). Older age (46–84 years), female sex, and Asian or Other race were significantly associated with higher likelihood of dual assessment (p<0.001).

Conclusion

CKD testing rates among DM adults in the MHS compared favorably to other national-level data. However, these results highlight the need to improve early CKD detection in these high-risk individuals as the initial critical step towards effective guideline-directed therapies.

The views expressed are those of the authors and do not reflect the official position of the Henry M. Jackson Foundation for the Advancement of Military Medicine, the Department of Defense, the Department of Health and Human Services, or the US Government.

Funding

• Other U.S. Government Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025dk2s1h46