Abstract: TH-PO0648
Progression to Urine Albumin-to-Creatinine Ratio (UACR) ≥ 700 mg/g in a Multinational Real-World Population with CKD: Results from the PROMISE Study
Session Information
- CKD: Clinical - Guidelines, Biomarkers, Progression, Procedures, Outcomes, and More
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Tuttle, Katherine R., Providence Health Care and University of Washington, Spokane, Washington, United States
- Burton, James, University of Leicester, Leicester, United Kingdom
- Pecoits-Filho, Roberto, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
- Karlberg, Olof, Sence Research AB, Uppsala, Sweden
- Adamsson Eryd, Samuel, AstraZeneca, Gothenburg, Sweden
- Aranda, Unai, AstraZeneca, Gaithersburg, Maryland, United States
- Bodegard, Johan, RWE Research, Oslo, Norway
- Enxing, Joshua, AstraZeneca, Cambridge, United Kingdom
- van Haalen, Heleen, AstraZeneca, Gothenburg, Sweden
- Levin, Adeera, University of British Columbia, Vancouver, British Columbia, Canada
- Chang, Tara I., Stanford University School of Medicine, Stanford, California, United States
- Svensson, Maria K., Uppsala University, Uppsala, Sweden
Background
Patients with severely increased albuminuria are at high risk of kidney failure, major adverse cardiovascular events and premature mortality. These risks are particularly pronounced for patients with UACR ≥ 700 mg/g. The aim of this study was to determine the frequency and risks of UACR increasing to ≥ 700 mg/g in real-world populations with UACR ≥ 300 mg/g.
Methods
Adults with CKD were identified from healthcare databases in England (Clinical Practice Research Datalink Aurum) and the USA (Optum's de-identified Clinformatics® Data Mart) using an index date of January 1, 2022, and from registries in Sweden using an index date of January 1, 2020. Patients with UACR ≥ 700 mg/g, T1D, ESKD/kidney failure or pregnancy were excluded. Patients were stratified by UACR levels at baseline. Risk of UACR ≥ 700 mg/g outcome was estimated by Cox proportional hazards models adjusted for age, sex, baseline eGFR, T2D and heart failure.
Results
We identified 78 011 patients from England, 16 567 from Sweden and 109 408 from the USA. Mean age at index was 67−75 years, 28−48% were female and 56−88% had type 2 diabetes. Proportions of patients progressing to UACR ≥ 700 mg/g within 15 months increased progressively by baseline UACR levels from 12–20 % in the 300–399 mg/g group to 29–37% in the 600–699 mg/g group (Figure). Hazard ratios (95% CI) for progression to UACR ≥ 700 mg/g in the 300–399 mg/g group were 6.6 (5.7–7.7), 4.4 (3.5–5.5) and 4.8 (4.4–5.3) in England, Sweden and the USA, respectively. Corresponding hazard ratios (95% CI) for the 600–699 mg/g group were 16.1 (13.7–18.9), 13.7 (11.1–17.0) and 10.4 (9.4–11.5).
Conclusion
Patients with CKD and UACR ≥ 300 mg/g often progress to ≥ 700 mg/g within a 15-month timeframe, highlighting the need for early detection and intervention in these high-risk patients.