Kidney Week

Abstract: FR-PO0351

Continuous Glucose Monitoring and Survival in a National Cohort of Veteran Patients with Diabetes on Dialysis

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

• Narasaki, Yoko, University of California Los Angeles, Los Angeles, California, United States

Yoko Narasaki, MS, PhD

• Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

• Kovesdy, Csaba P., University of Tennessee Health Science Center College of Medicine - Nashville Campus, Nashville, Tennessee, United States

Csaba P. Kovesdy, MD, FASN

• Li, Zhaoping, University of California Los Angeles, Los Angeles, California, United States

Zhaoping Li

• Klonoff, David Charles, University of California San Francisco, San Francisco, California, United States

David Charles Klonoff, MD

• You, Seungsook, University of California Los Angeles, Los Angeles, California, United States

Seungsook You, MS

• Torres Rivera, Silvina, University of California Los Angeles, Los Angeles, California, United States

Silvina Torres Rivera

• Nguyen, Danh V., University of California Irvine, Irvine, California, United States

Danh V. Nguyen, PhD

• Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States

Connie Rhee, MD, MS

Background

ESKD patients with diabetes mellitus (DM) are at heightened risk of hypo- and hyperglycemia, which are risk factors for adverse clinical outcomes. While traditional glycemic markers (HbA1c, self-monitored blood glucose) have limitations in their accuracy, convenience, and accessibility in ESKD, continuous glucose monitoring (CGM) provides automated, less invasive glucose measurements and more comprehensive glycemic data than conventional measures. However, it remains unclear as to whether CGM is associated with improved clinical outcomes in dialysis patients.

Methods

Using linked national VA, USRDS, and Medicare data, we examined the association between incident CGM use vs. non-CGM use and survival among US Veteran dialysis patients with DM. We evaluated diabetic Veteran dialysis patients with CGM use vs. non-CGM use over the period of 1/2012-12/2023 who were matched by propensity score (PS) in a 1:1 ratio to address confounding by indication, and patients were followed for all-cause mortality events through 2/2025. We examined the association of incident CGM use vs. non-CGM use with mortality risk using unadjusted and doubly-adjusted Cox models.

Results

There were 1545 patients with incident CGM use and 1545 with non-CGM use in the 1:1 PS-matched cohort. Compared with non-CGM use, CGM use was associated with lower mortality risk in unadjusted PS-matched analyses: HR (95%CI) 0.89 (0.80, 0.98). These findings were robust in doubly-adjusted Cox models (ref: non-CGM use): 0.83 (0.75, 0.92).

Conclusion

In Veteran dialysis patients with DM, CGM use was associated with better survival vs. non-CGM use. Further studies are needed to determine underlying mechanisms, as well as the impact of CGM on other hard endpoints and patient-centered outcomes in ESKD.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025448vy46h