Abstract: PUB075
Treatment Gap in Nephroprotection: Analysis of Prior Use of Drugs with Nephroprotective Effects in Patients with Incidental Diagnosis of Diabetic Kidney Disease
Session Information
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Lira, Deyanira, Universidad Autonoma de Tamaulipas Facultad de Medicina Dr Alberto Romo Caballero, Tampico, Tamps., Mexico
- Avila Velazquez, Jose Luis, Hospital Angeles Tampico, Tampico, Tamps., Mexico
- Altamirano Castro, Jose Fernando, Universidad Autonoma de Tamaulipas Facultad de Medicina Dr Alberto Romo Caballero, Tampico, Tamps., Mexico
- Cadena Nuñez, Bertha, Hospital Angeles Tampico, Tampico, Tamps., Mexico
- Gamez Garza, Marco Antonio, Universidad Autonoma de Tamaulipas Facultad de Medicina Dr Alberto Romo Caballero, Tampico, Tamps., Mexico
Background
The diagnosis and staging of Chronic Kidney Disease (CKD) are based on an assesment that primarily includes estimated glomerular filtration rate (eGFR) and albuminuria range. However, CKD is often diagnosed incidentally in hospitalized patients. To assess the impact of the previous use of drugs with nephroprotective effects (DNE)- such as sodium-glucose co-transporter 2 inhibitors (iSGLT2), GLP-1 receptor agonists (GLP-1ra), renin-angiotensin system inhibitors (RASi), and/or nonsteroidal mineralocorticoid receptor antagonists (nsMRA)- on patients with an incidental CKD diagnosis during hospitalization in the Internal Medicin ward.
Methods
Observational, cross-sectional study in patients admitted to the Internal Medicin ward over a six-month period. Patients with Diabetes Mellitus Type 2 (DM2) and an incidental diagnosis of CKD defined as an albumin-to-creatinine ratio (ACR) over 30 mg/g and eGFR below 60 mL/min/1.73 m2, were selected. Previous use of DNE was documented through patient interviews and review of medical records.
Results
Within the analyzed population, 42.4% were in stage G3 (G3a 24.2% and G3b 18.2%), 36.4% were in stage G4, and 21.5% of patients were in stage G5 (according to KDIGO) at the time of evaluation. Regarding treatment before admission, none of the patients had received nsMRA's or GLP1ra. Additionally, only 27-3% were receiving treatment with a RASi, and just 9.1% had previously used iSGLT2.
Conclusion
The data analyzed included various clinical variables, CDK stages G3a to G5 (without renal replacement therapy), as well previous use of DNE. Among the clinical variables, advanced age was associated with a higher risk of advanced CKD. The previous use of DNE showed a trend toward a lower risk of advanced CKD, even in elderly patients. These findings reflect a low implementation of pharmacological strategies with proven nephroprotective benefits in patients with advanced Diabetic Kidney Disease. Despite current recommendations from international guidelines, a significant treatment gap persist, possibly due to barriers in medication access, outdated clinical protocols, and limited availability in the public healthcare system.
Funding
- Government Support – Non-U.S.