Physicians’ chronic kidney disease (CKD) awareness in type 2 diabetes (T2D) is associated with CKD severity, according to a new study presented this week at the American Diabetes Association’s 80th Virtual Scientific Sessions.
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.
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.