Kidney Week

Abstract: TH-PO1005

Renal Protective Treatment Use for Non-Diabetic CKD in Japan, Sweden, and the United States

Session Information

• CKD Epidemiology, Risk Factors, Prevention - I
  November 02, 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

• Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada

Navdeep Tangri,

• Svensson, Maria K., Department of Medical Sciences, Renal Medicine, Uppsala University, Uppsala, Sweden

Maria K. Svensson,

• Bodegard, Johan, CVRM Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden

Johan Bodegard,

• Adamsson Eryd, Samuel, CVRM Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden

Samuel Adamsson Eryd,

• Thuresson, Marcus, Statisticon AB, Uppsala, Sweden

Marcus Thuresson,

• Sofue, Tadashi, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan

Tadashi Sofue,

Background

Chronic kidney disease (CKD) is an underdiagnosed disease affecting 10% of people worldwide. Appropriate management of CKD delays progression and reduces its burden. Renin–angiotensin system inhibitors (RASis) have been the mainstay of CKD treatment until recently. Here we describe the use of RASis and the sodium–glucose co-transporter-2 inhibitor dapagliflozin in a contemporary population of patients with CKD.

Methods

This study used secondary data extracted from electronic health records or claims data sources. Adult patients with CKD (either two estimated glomerular filtration rate [eGFR] measurements ≥ 90 days apart of which both were ≤ 60 mL/min/1.73 m² or an eGFR ≤ 60 mL/min/1.73 m² followed by a CKD diagnosis) who were new RASi or dapagliflozin users during 2021–2023 were included. Patients with type 1 or gestational diabetes, stage 5 CKD or on dialysis were excluded. RASi and dapagliflozin doses and persistence were assessed in the year following initiation.

Results

Overall, 159 220 patients were included (Japan, 57 222; Sweden, 10 861; USA, 91 137). Median ages were 75, 72 and 72 years, and 63%, 66% and 52% were males in Japan, Sweden and the USA, respectively. Of patients without type 2 diabetes, a high proportion receiving dapagliflozin remained on the evidence-based 10 mg target dose (Figure). A large proportion of patients treated with RASis received low doses. At 12-month follow-up, dapagliflozin persistence was approximately 65%, 80% and 55% in Japan, Sweden and the USA, respectively, and was 34%, 75% and 64% for RASi, respectively.

Conclusion

CKD treatment with dapagliflozin was associated with a high likelihood of receiving and remaining on target dose compared with RASi treatment. Efforts to maintain patients on renal protective treatment are needed.

Funding

• Commercial Support – AstraZeneca