Kidney Week

Abstract: FR-OR01

Patterns of Care among Patients with Documented CKD in the United States

Session Information

• CKD: Care Patterns and Novel Therapeutic Approaches
  October 25, 2024 | Location: Room 25, Convention Center
  Abstract Time: 04:30 PM - 04:40 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Kovesdy, Csaba P., University of Tennesse, Memphis, Tennessee, United States

Csaba P. Kovesdy, MD, FASN

• Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States

Satabdi Chatterjee, MS, PhD

• Levy, Adrian R., Dalhousie University, Halifax, Nova Scotia, Canada

Adrian R. Levy, PhD

• Stackland, Sydnie, Panalgo LLC, Boston, Massachusetts, United States

Sydnie Stackland, MS

• Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States

Bonnie M.k. Donato, MA, PhD

• Zhang, Ling, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States

Ling Zhang, MD, MS, MPH

Background

Guidelines for pharmacotherapy in chronic kidney disease (CKD) recommend a multifactorial strategy to slow kidney disease progression by inhibiting the renin-angiotensin-aldosterone system (RAASi; using angiotensin-converting enzyme inhibitors [ACEi] or angiotensin receptor blockers [ARB]) and lowering cardiovascular risk by using statins. In light of newer therapies available for CKD and the underdiagnosis of this condition, little is known regarding patterns of care in patients prior to documenting diagnosis. This study aimed to compare the patterns of care for RAASis and statins at the onset of CKD using laboratory data; vs documentation of CKD using ICD codes.

Methods

A retrospective study using electronic health record-linked claims data from 2009-2020 Optum® Market Clarity was conducted. The cohort included adults with two estimated glomerular filtration rate (eGFR) measures <60mL/ min/1.73 m², 3-12 months apart, followed by documented clinical diagnosis of CKD (using ICD 9/10 codes). The proportion of patients who were prescribed, administered, or ordered RAASis and/ or statins within ±90 days of: the second eGFR<60 mL/min/1.73 m² (index date), and the date of first documented diagnosis in claims were computed.

Results

A total of 1.39 million adults with laboratory evidence of CKD (mean [±SD] age 71 [±10]; 63% women; 87% Caucasian) were identified; of them, 740,088 (53.1%) received a documented diagnosis of CKD during follow-up, and formed the study cohort. Among those with documented CKD, 39% received RAASis and 36% received statins at index date; utilization increased to 46% and 45% respectively, at diagnosis. On average, use of RAASis increased from 38% between 2010-2012 to 48% between 2018-2020, while use of statins increased from 37% to 48% during the same time period.

Conclusion

Despite the utilization of RAASis and statins increasing between onset of CKD and documented diagnosis, the overall low uptake of these guideline-recommended therapies (<50%) reinforces the need to improve pharmacologic management in CKD. As new treatments become available, optimizing care using evidence-based guideline-recommended therapies offers the opportunity of reducing risk of cardiorenal syndrome, and improving outcomes in CKD.

Funding

• Commercial Support – Boehringer Ingelheim