Kidney Week

Abstract: SA-PO1095

Incidence of CKD in Prediabetes

Session Information

• CKD Epidemiology, Risk Factors, Prevention - III
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Alicic, Radica Z., Providence Health and Services, Spokane, Washington, United States

Radica Z. Alicic,

• Duru, Obidiugwu, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Obidiugwu Duru,

• Jones, Cami R., Providence Health and Services, Spokane, Washington, United States

Cami R. Jones,

• Kornowske, Lindsey M., Providence Health and Services, Spokane, Washington, United States

Lindsey M. Kornowske,

• Daratha, Kenn B., Providence Health and Services, Spokane, Washington, United States

Kenn B. Daratha,

• Pavkov, Meda E., Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Meda E. Pavkov,

• Koyama, Alain K., Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Alain K. Koyama,

• Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Susanne B. Nicholas,

• Neumiller, Joshua J., Washington State University, Pullman, Washington, United States

Joshua J. Neumiller,

• Miyamoto, Yoshihisa, Centers for Disease Control and Prevention, Atlanta, Georgia, United States

Yoshihisa Miyamoto,

• Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States

Keith C. Norris,

• Tuttle, Katherine R., Providence Health and Services, Spokane, Washington, United States

Katherine R. Tuttle,

Group or Team Name

• CURE-CKD Registry.

Background

Diabetes complications may occur in persons with prediabetes mellitus (PDM) defined by hyperglycemia below the threshold for diabetes diagnosis. The study aim was to assess the incidence of chronic kidney disease (CKD) in PDM in a real-world population.

Methods

The study population was derived from the Center for Kidney Disease Research, Education, and Hope (CURE-CKD) Registry of electronic health records from Providence and UCLA Health systems. PDM was defined by HbA1c 5.7-6.4%, 2 measures of fasting (100-125 mg/dL) or random (140-199 mg/dL) blood glucose at least 1 day apart, or ICD-9/10 codes. CKD was defined by estimated CKD-EPI 2021 glomerular filtration rate (eGFR) <60 mL/min/1.73 m², urine albumin/creatinine ratio ≥30 mg/g, or urine protein/creatinine ratio ≥0.15 g/g ≥90 days apart, or ICD-9/10 codes. Incidence of CKD was estimated in persons ≥18 years old with PDM and without CKD in the previous 6 months. Estimates for 2015-2020 were standardized to the 2020 US population. Incidence rate ratios (IRR) compared CKD incidence within age, race/ethnicity, and sex groups.

Results

Persons with PDM (N=256,829) were 55% women and 56±15 years old. At baseline, mean eGFR was 93±16 mL/min/1.73 m²; mean HbA1c and systolic blood pressure were 5.8±0.3% and 127±16 mmHg. After a median follow-up of 2.6 years (interquartile range 1.5-3.8), CKD was identified in 7%. Of these, 43% had an eGFR <60 mL/min/1.73 m². Standardized incidence rate of CKD was 30.4 cases/1,000 person-years (95% CI 29.8-31.0). IRRs are presented in the Figure.

Conclusion

CKD developed among 1 in 14 persons with PDM in a short period of time. Older age and non-White race groups with PDM, except the Asian patient group, had higher incidence of CKD compared to the White group, whereas women had lower risk than men. These results suggest that certain demographic groups may benefit from targeted awareness, detection, and strategies to prevent CKD progression.

Funding

• Other U.S. Government Support