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Abstract: FR-PO936

Prevalence and Awareness of Kidney Disease Among Individuals With Prediabetes

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Li, Yiting, University of Michigan, Ann Arbor, Michigan, United States
  • Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States
  • Veinot, Tiffany C., University of Michigan, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
  • Herman, William H., University of Michigan, Ann Arbor, Michigan, United States
  • Koyama, Alain, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
Background

About 96 million US adults have prediabetes; 80% are unaware they have the condition. Prediabetes can progress to type 2 diabetes and complications such as chronic kidney disease (CKD). Here we compare the prevalence of CKD and its awareness among those with prediabetes and diabetes in the US.

Methods

Analysis included 47,000 U.S. adults aged 20+ years in the National Health and Nutrition Examination Survey (NHANES, 2001 to Mar 2020). Prediabetes was defined as HbA1c 5.7% to 6.4%; diabetes (DM) by self-report, medication, or HbA1c ≥ 6.5%. CKD was defined by eGFR < 60 ml/min/1.73m2 or albuminuria. CKD awareness and health behaviors were self-reported and nutritional intake was estimated from daily recall questionnaires. Survey weighted logistic regression was used to model changes in prevalence and awareness over time.

Results

Compared to adults with diabetes, those with prediabetes were younger and more likely to be female and Black (p<0.001). Those with prediabetes had a lower, though substantial comorbidity burden: 19% with CKD but only 7% aware of their condition. During the study, CKD prevalence among individuals with prediabetes decreased from 22% to 17% (p=0.03), with no significant change in age and comorbidities, but with improvements in lifestyle behaviors (p<0.001): increase in moderate physical activity (45.7% to 66.3%) and decline in sugar intake (123 g to 108 g). In addition, CKD awareness among individuals with prediabetes rose from 4.8% to 8.1%, although not statistically significant (p=0.18).

Conclusion

Nearly 1 in 5 individuals with prediabetes has CKD, yet only 7% were aware of their kidney disease. While improvements have been seen, opportunities remain to intervene at this potentially reversible stage, including improvement in diagnosis and awareness of prediabetes and in response to the high burden of CKD even among those with prediabetes.