Physicians’ CKD awareness in T2D is linked with CKD severity, suggests a new study presented this week at the American Diabetes Association’s 80th Virtual Scientific Sessions.
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Authors of the retrospective study found that physician awareness of CKD is linked with CKD severity as related to estimated glomerular filtration rate (eGFR), but not to albumin-to-creatinine ratio (ACR).
Researchers examined 136 157 patients aged ≥ 18 years with an electronic health record (EHR) T2D diagnosis that were seen in clinic in 3 consecutive periods; median age was 62 years old. Overall, 77.9% of patients had eGFR measured, 60.6% had ACR measured, and 58.8% had both.
CKD stages were defined by eGFR (represented by G1-G5) and ACR (represented by A1-A3):
The frequency of CKD stages was determined for all patients, regardless of EHR CKD diagnosis.
Researchers found that ACR was measured more often in less severe stages of CKD (Chi-Square, p<.001), and patients in G3a had a CKD diagnosis on their problem list less often vs those in G3b-5 (Chi-Square, p<.001).
Also, among patients in G3a, an EHR CKD diagnosis was present in 53.8%, 58.4%, and 60.1%, while among those in G3b-5 an EHR CKD diagnosis was present in 79.8%, 85.6%, and 84.9% in periods 1-3, respectively.
Among all patients in A2-A3, an EHR CKD diagnosis was present in 44.9%, 44.5%, and 45.7% in periods 1-3, respectively.
“Our data also indicates that despite an initial increase in eGFR-driven CKD awareness between periods 1 and 2, this has leveled off. Not having an EHR CKD Dx suggests lack of physician (and patient) CKD awareness and can potentially lead to suboptimal care,” concluded study authors.
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Source: Schempf J, Freese RL, Caramori L, Harindhanavudhi T. Physicians’ Chronic Kidney Disease (CKD) Awareness over Time in Type 2 Diabetes (T2D). Presented at: American Diabetes Association 80th Scientific Sessions; June 12-16, 2020. Abstract 03-B.