Abstract: SA-PO169
Declining CKD Prevalence Among Patients with Diabetes in the United States
Session Information
- Diabetic Kidney Disease: Clinical - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
- Zhang, Xiaosong, University of Michigan, Ann Arbor, Michigan, United States
- Herman, William H., University of Michigan, Ann Arbor, Michigan, United States
- Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background
Diabetes mellitus (DM) is a major risk factor for the development of chronic kidney disease (CKD) and is the assigned primary cause for almost half of all new end stage renal disease cases in the US. Diabetics with high blood pressure, poor glucose control, inherited tendency, and poor diet are at an increased risk of developing CKD. In this work, we sought to examine the prevalence of CKD among diabetics over time in the US.
Methods
Data from 5,278 patients with DM (diagnosed, taking medication, or HbA1c > 7%) from the National Health and Nutrition Examination Survey (NHANES, 2001-2016) was examined to estimate prevalence of CKD in 4-year cohorts, using population survey weights. CKD was defined either as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or urine albumin-to-creatinine ratio (UACR) > 30 mg/g. Weighted logistic regression was used to assess significance of this decline.
Results
The prevalence of CKD among patients with DM declined steadily from 2001 to 2016. In contrast, the prevalence of CKD among patients with hypertension (HTN; diagnosed, receiving antihypertensive medication, or blood pressure >140/90) did not show a similar trend. The decline in CKD prevalence for DM is primarily driven by a lower prevalence of albuminuria (UACR > 30 mg/g) rather than low eGFR, which appeared stable over these years. This trend was significant with an OR=0.90 (95% CI: 0.85-0.96) per each 4-year more recent time period and increased in magnitude when adjusted for patient demographics (OR=0.88, 95% CI: 0.82-0.94).
Conclusion
The prevalence of CKD, in particular albuminuria, among patients with DM has decreased steadily in the US over the past 16 years, while its prevalence among patients with HTN has been stable. Future work will investigate potential reasons for this steady decline, such as greater awareness of diabetes and its complications, improvements in blood pressure control, glycemic control, adherence to healthier diet, weight control, and physical exercise.
Funding
- NIDDK Support