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Abstract: FR-PO0349

Advancing CKD Screening and Therapy Provision for Hispanic/Latino and Black Patients with Type 2 Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Sinclair, Matthew R., Duke University School of Medicine, Durham, North Carolina, United States
  • Davenport, Clemontina A., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Diamantidis, Clarissa Jonas, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
Background

CKD progression disproportionately burdens Hispanic/Latino (Hispanic) and non-Hispanic Black (NHB) individuals, partly due to high type 2 diabetes (T2D) prevalence. Annual urine albumin-creatinine ratio (UACR) screening, recommended for early CKD detection, is performed in <25% of Hispanic and NHB individuals with T2D, contributing to decreased prescribing of renin-angiotensin-aldosterone system inhibitors (RAASis), sodium-glucose co-transporter 2 inhibitors (SGLT2is), and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). We piloted a primary care provider (PCP)-facing intervention, Riñones Dulces, to promote evidence-based CKD screening and medical management among Hispanic and NHB individuals with T2D.

Methods

Electronic health record (EHR) was queried to identify Hispanic and NHB individuals with T2D at two Duke clinics with an upcoming PCP appointment. A clinical champion and pharmacist made recommendations via EHR to the PCPs prior to the upcoming appointment regarding performing a UACR and/or optimizing medical management. Three months post-visit, we assessed whether recommendations were followed. PCPs were surveyed post-intervention to determine satisfaction.

Results

Among 189 screened patients, 97 (51.3%) received recommendations. Of 68 patients due for a UACR, 40 received it (59%) after the intervention recommendation; 16 of 43 were prescribed an SGLT2i or GLP-1 RA (37.2%); 2 of 9 patients were prescribed a RAASi (22.2%). Figure 1 shows percentage of eligible patients meeting recommendations pre- and post-intervention. Seven PCPs responded to the post-survey, with 5 (71%) finding the UACR recommendations helpful, and 6 (88%) finding the medication recommendations helpful.

Conclusion

Riñones Dulces improved UACR screening and medical management among Hispanic and NHB individuals with T2D at risk for CKD development or progression, with positive uptake by PCPs. To improve disparate CKD outcomes, further testing of Riñones Dulces in other clinic settings is necessary.

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)