Kidney Week

Abstract: SA-PO0400

Characteristics of Patients with Comorbid CKD and Hypertension in the United States and Finland

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Gordin, Daniel, Department of Nephrology, University of Helsinki and Helsinki University Hospital; Minerva Foundation Institute for Medical Research, Helsinki, Finland

Daniel Gordin, MD, PhD

• Niiranen, Teemu, Department of Internal Medicine, University of Turku, Turku, Finland

Teemu Niiranen, MD

• Ambruso, Sophia L., Idaho Nephrology Associates, Boise, Idaho, United States

Sophia L. Ambruso, DO, FASN

• Danelich, Ilya, CVRM, BioPharmaceuticals Medical, AstraZeneca, Wilmington, Delaware, United States

Ilya Danelich

• Norris, Tom, CVRM Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden

Tom Norris, PhD

• Finne, Patrik, Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

Patrik Finne, MD, PhD

Background

Chronic kidney disease (CKD) and hypertension (HTN) are interrelated, with 60–80% of patients with CKD having uncontrolled blood pressure (BP), exacerbating kidney function decline, and increasing cardiovascular (CV) risk. While first-line guideline-directed medical therapies (GDMT) for most patients with CKD include renin–angiotensin system inhibitors (RASi) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), their real-world adoption is variable. Characterizing patients by GDMT status can provide essential context to qualify treatment gaps and identify clinical profiles associated with underuse.

Methods

EnligHTN-CKD is a multi-country observational study using medical claims and electronic medical records to assess burden of comorbid CKD with HTN. For this analysis, data were sourced from Optum de-identified Clinformatics^® Data Mart (United States [US]) and nationwide registries (Finland [FI]). Patients with incident comorbid CKD with HTN from 1/1/2021 were included. Characteristics at index stratified by GDMT (defined as RASi prescribed together with SGLT2i) status were summarized by country.

Results

803,386 (US) and 18,226 (FI) pts with comorbid CKD with HTN were included. The percentage of patients in the US and FI who were on GDMT within 30 days of identification as comorbid was 3.9% (n=31,229) and 8.8% (n=1603), respectively. Only 11.1% of patients were on GDMT at 12 months (FI). Compared with patients on GDMT within 30 days, those not on GDMT were older (US: 75 vs 70 years; FI: 77 vs 74 years), had higher systolic BP (US: 131.9 vs 128.8 mmHg; FI: 143.1 vs 138.6 mmHg), and were less likely to have associated comorbidities (heart failure: US: 22.8% vs 37.1%, FI: 22.9% vs 31.8%; type 2 diabetes: US: 46.0% vs 90.0%, FI: 37.9% vs 87.9%). Patients not on GDMT were less likely to be taking mineralocorticoid receptor antagonists (US: 5.9% vs 17.4%; FI: 6.4% vs 15.9%), glucagon-like peptide-1 receptor agonists (US: 4.8% vs 24.7%; FI: 3.0% vs 14.8%), and statins (US: 54.8% vs 84.9%; FI: 49.5% vs 72.5%).

Conclusion

Despite cardiorenal benefits, GDMT were highly underutilized amongst patients with comorbid HTN with CKD. As SGLT2i are also used for glycemic indications, most patients on GDMT had diabetes, underscoring the need to heighten awareness and expand appropriate prescribing for renal and CV protection in patients with CKD and HTN, irrespective of diabetes status.

Funding

• Commercial Support – AstraZeneca