Abstract: SA-PO1074
Hypertensive Patients Should be Routinely Screened for CKD
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Leiba, Adi, Assuta Ashdod Hospital, Ashdod, South, Israel
- Angel-Korman, Avital, Assuta Ashdod Hospital, Ashdod, South, Israel
Background
Hypertension is a well-established risk factor for CKD , but awareness for early detection of CKD especially among non-diabetic hypertensive patients is lacking. Early detection of CKD can promote treatment with novel therapies such as SGLT-2 inhibitors or new MRAs.
The aim of this study was to estimate referral rates and the extent of positive screening results for CKD (i.e. reduced eGFR and/or proteinuria), in a large scale community-based registry.
Methods
In this real-life, retrospective, observational study we utilized the Maccabi Healthcare Services (MHS) database. Included in the study, were patients over the age of 18 years, who had entered the MHS HTN registry in the past 10 years before February, 2024, and did not have diabetes or CKD.
Early detection of CKD was defined as a PCP referral for blood test (serum creatinine (sCr)) and urine protein quantification (either uACR, uPCR or 24 hour urinary albumin/protein) within 12 months of HTN diagnosis, between 2014 and 2024. CKD diagnosis was defined according to the KDIGO guidelines as eGFR<60ml/min/1.73 square meter and/or urine albumin >30 mg or protein >150 mg per 24 hours or as a ratio to urine creatinine. Only those who had both a sCr test for eGFR estimation and a urine test for protein quantification, were considered as being screened for early detection of CKD.
Results
A total of 1,875,479 MHS members were over 18 years on February 2024, and 121,056 of them had a diagnosis of HTN within the past 10 years (2014-2024). Of those, 76,425 (63.1%) examinees had both urine and blood tests sent within a year after HTN diagnosis . CKD according to the above indices was found in 9958 examinees (13%). Importantly, lifetime prevalence of CKD within all adult MHS members is significantly lower - 5.7%, which indicates the extra burden of disease among those with HTN.
Considering a 13% prevalence of CKD in the hypertensive population, early referral of the remaining 36.9% of patients who were not sent for the full blood and urine workup, would be expected to detect an extra 5815 patients with CKD (13% of 44,631 patients), 4.8% of the overall hypertensive cohort.
Conclusion
A one-time referral of every new hypertensive patient, for both urinary sCr and urine protein estimation, is a cost effective and simple tool for early CKD detection and may have a positive impact on CKD progression and cardiovascular complications of both HTN and CKD.