Kidney Week

Abstract: FR-PO0372

Testing for CKD in Patients with Hypertension (HTN) in the US Military Health System (MHS)

Session Information

• Hypertension and CVD: Clinical - 2
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

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

Robert Nee, MD, FASN

• 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

Background

The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend testing persons at risk for and with CKD using both urine albumin measurements and estimated glomerular filtration rate (eGFR). Given the lack of published data, we evaluated dual CKD testing in the HTN population within the MHS, a large single-payer health care network.

Methods

Using the MHS Data Repository (2016−2022), we analyzed the annual prevalence of nonpregnant HTN adults ± CKD based on ICD-10 codes who were tested with both eGFR and urine albumin measurements (urine albumin-to-creatinine ratio [uACR] and urine albumin concentration). We conducted logistic regression analyses to assess the association of demographic factors to dual lab testing, adjusting for rank, active-duty status, and comorbidities.

Results

In 2022, 336,248 (13.2%) of 2,544,963 adults in the MHS had HTN (median age 58, interquartile range [IQR] 50−63 years; male 53.4%, White 47.5%, Black 22.2%, Asian American/Pacific Islander 6.4%, Native American/Alaskan Native 0.6%, and Other 6.3%; median eGFR = 81, IQR 62−97 ml/min/1.73m², median uACR = 20, IQR 8−74 mg/g). About 37% of HTN+/CKD+ and 24% of HTN+/CKD- were tested for both eGFR and albuminuria. During 2016−2022, dual testing in the overall HTN cohort ranged from 25% to 27% (Fig). Older age (46−84 years), female sex, and being Asian, Black, or other race were associated with higher likelihood of dual testing (p<0.001).

Conclusion

Testing for CKD with both eGFR and urine albumin measurements was low among HTN adults in the MHS. These results highlight the need to increase CKD testing in these high-risk individuals as an initial 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, Inc., 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.2025c5vyrgtn