Abstract: TH-PO1049
Geographic Differences in CKD Prevalence and Testing for Albuminuria at US Federally Qualified Health Centers
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Fraunhofer, Linda, Laboratory Corporation of America Holdings, Burlington, North Carolina, United States
- Ennis, Jennifer, Laboratory Corporation of America Holdings, Burlington, North Carolina, United States
- Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
- Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
Background
Federally Qualified Health Centers (FQHCs) serve medically underserved populations disproportionately affected by diabetes and hypertension, both risk factors for chronic kidney disease (CKD). However, the prevalence of CKD in this at-risk population remains poorly characterized. This study evaluates the prevalence of CKD (Stage 3 or higher), and adherence to recommended follow-up testing among FQHC patients across the U.S.
Methods
We conducted a cross-sectional analysis of 2023 Labcorp laboratory data from ~4M FQHC patients (18 years or older) nationwide. Low eGFR (<60 ml/min/1.73m2) was used to identify Stage 3 or higher, CKD. Guideline-concordant care was defined as receipt of urine albumin-to-creatinine ratio (uACR) testing among patients CKD. Spatial mapping and multivariate clustering were used to examine geographic patterns in disease burden and adherence to uACR testing.
Results
FQHC patients were on average 50 years old with 40% males. The prevalence of diabetes and CKD was 23% and 8%, respectively. Significant regional variation in CKD prevalence was observed (A). The Southeast and Pacific Northwest exhibited the highest, while the Northeast and West showed the lower estimates of CKD prevalence. Adherence to uACR testing among patients with CKD was inconsistent, with some high CKD prevalence states demonstrating low adherence (B). Cluster analysis identified groups of states with high CKD burden and low uACR testing (e.g., Mississippi, Alabama, West Virginia), and others with lower CKD burden and higher adherence to testing (e.g., Arizona, Illinois).
Conclusion
Substantial disparities exist in the prevalence of CKD and follow-up uACR testing among FQHC patients across the U.S. States with the highest CKD burden often have the lowest testing adherence. These findings underscore the need for national kidney health surveillance and targeted interventions to improve early detection and care delivery in high-risk populations.
Funding
- Commercial Support – Labcorp provided the laboratory data but no funding.