Kidney Week

Abstract: SA-PO788

Burden of Metabolic Complications with Advancing CKD in the Irish Health System

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Browne, Leonard, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Leonard Browne,

• O'Hara, Paul, Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Paul O'Hara,

• Mc Monagle, Edward Philip, University Hospital Limerick, Limerick, Ireland

Edward Philip Mc Monagle,

• Stack, Austin G., Graduate Entry Medical School, University of Limerick, Limerick, Ireland

Austin G. Stack,

Background

The prevalence of Chronic Kidney Disease (CKD) exceeds 15% in the Irish health system and is associated with adverse clinical outcomes. The goal of this study was to describe the burden of common metabolic complications in CKD and assess the impact of deteriorating kidney function.

Methods

Utilising data from the National Kidney Disease Surveillance System, we conducted a cross sectional study of adult patients, age > 18 years, from the Midwest region in 2014 with data on serum creatinine measurements and metabolic indicators of anaemia, nutrition, metabolic bone disease and acidosis. Dialysis patients were excluded. The following definitions were used: anaemia: haemoglobin <13 g/dL in men and <12 g/dL in women; hyperkalaemia: K+ > 5.5 mmol/L; hypoalbuminaemia; serum albumin <35g/L, metabolic acidosis: bicarbonate < 22 mmol/L, and hyperphosphatemia: phosphate >1.5 mmol/L. Logistic regression models explored associations of estimated glomerular filtration rate (eGFR) with each metabolic complication expressed as adjusted odds ratio (OR) and 95% Confidence intervals.

Results

There were 133,558 adults with average age 54.3 (±17.7) years and eGFR 87.9(±21.1) ml/min/1.73m². The prevalence of metabolic complications were as follows: acidosis (28.9%), anaemia (13.6%), hyperkalaemic (13.1%), hypoalbuminaemia (9.9%), and hyperphosphatemia (2.3%). In multivariate models adjusting for age and sex only, each 5mL/min/1.73m² fall in eGFR was associated with higher odds of anaemia, [OR 1.08 (95% CI; 1.07-1.09)]; hyperkalaemia [OR 1.09 (95% CI; 1.08-1.10], hypoalbuminaemia, [OR 1.02 (1.01-1.03)], metabolic acidosis [OR 1.03 (95% CI; 1.02-1.04)], and hyperphosphatemia [OR 1.23 (95% CI; 1.21-1.26)].These findings were accentuated in the elderly (Table 1).

Conclusion

The burden of CKD-related metabolic complications is substantial within the Irish health system and increases with advancing CKD. Patients with low eGFR, especially the elderly, are at increased risk for several serious but treatable metabolic complications. Early identification and treatment of these disorders may lead to improved patient outcomes

Funding

• Government Support - Non-U.S.