Kidney Week

Abstract: SA-PO0416

Continuous Glucose Monitoring and Risk of Progression to ESKD in a National CKD Cohort

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

• You, Amy Seungsook, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Amy Seungsook You, MS

• Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States

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

• Narasaki, Yoko, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Yoko Narasaki, MS, PhD

• Zisman-Ilani, Yaara, Temple University, Philadelphia, Pennsylvania, United States

Yaara Zisman-Ilani, MA, PhD

• Klonoff, David Charles, Diabetes Technology Society, Burlingame, California, United States

David Charles Klonoff, MD

• Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy, MD, FASN

• Gee, Patrick O., iAdvocate, Inc., Richmond, Virginia, United States

Patrick O. Gee, PhD

• Siu, Man Kit Michael, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Man Kit Michael Siu, MD, MS

• Novoa Vargas, Alejandra, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Alejandra Novoa Vargas, MPH

• Daza Aguilar, Andrea C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Andrea C. Daza Aguilar

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

Danh V. Nguyen, PhD

• Rhee, Connie, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Connie Rhee, MD, MS

Background

The Advancing American Kidney Health Initiative has identified prevention of CKD progression and reduction of ESKD as national priorities. Diabetes mellitus (DM), the leading cause of ESKD, is frequently complicated by dysglycemia and contributes to adverse CV outcomes. Continuous glucose monitoring (CGM) provides comprehensive, real-time assessment of glycemia and has been shown to improve glycemic control in non-CKD patients. Yet it is unclear whether CGM use is associated with lower risk of CKD progression. We thus examined incident CGM use (newly-prescribed CGM) and risk of progression to ESKD in adults with DM and incident CKD in a national cohort.

Methods

Using the Optum Labs Data Warehouse (OLDW), which contains de-identified administrative claims, including medical/pharmacy claims and enrollment records for commercial/Medicare enrollees, and EHR data, we identified adults with DM and incident CKD (≥2 eGFRs <60 mL/min/1.73m² separated by ≥90 days between 1/1/18–12/31/24). We compared risk of progression to ESKD among new users of CGM vs. non-users. CGM users and non-users were propensity score (PS)-matched in a 1:1 ratio to mitigate confounding by indication and were followed from the 2^nd qualifying (index) eGFR <60 through 12/31/25. Associations with progression to ESKD were evaluated using unadjusted and doubly-adjusted Cox models.

Results

There were 21,304 matched pairs of incident CGM users and non-CGM users (total N=42,608) after PS matching. Compared with non-CGM users, CGM users had lower risk of progression to incident ESKD in unadjusted and doubly-adjusted PS-matched analyses: HRs (95%CIs) 0.71 (0.66, 0.76) and 0.64 (0.60, 0.69), respectively (Figure).

Conclusion

In a national cohort of patients with CKD and DM, CGM users had lower risk of progression to ESKD vs. non-users. These findings suggest a role for CGM in mitigating kidney disease progression in high-risk populations. Prospective studies are needed to determine if these associations are causal and to assess the broader impact of CGM on CKD outcomes.

Funding

• NIDDK Support