Incident CKD in Diabetes, Hypertension, and Prediabetes

<p> <h6> BACKGROUND </h6></p><p> Hypertension (HTN), diabetes mellitus (DM), and prediabetes (PDM) are major risk factors for chronic kidney disease (CKD), yet community-level longitudinal studies of CKD incidence are lacking. The study aim was to determine CKD incidence rates in these at-risk groups by practice- and guideline-based definitions. <h6> METHODS </h6></p><p> The Center for Kidney Disease Research, Education, and Hope (CURE-CKD) registry is curated from electronic health records with clinical and administrative data from two large non-profit healthcare systems. CKD incidence (95% CI) in adults was calculated over 4, two-year time periods during 2010-2017 adjusted for age, sex, and race/ethnicity. CKD was identified by 2 definitions: 1. Practice-based, CURE-CKD: At least 2 laboratory measures for CKD &ge;90 days apart (estimated glomerular filtration rate - eGFR/min/1.73m2, urine albumin/creatinine ratio - UACR &ge;30 mg/g, or urine protein/creatinine ratio - UPCR &ge;150 mg/g) or CKD administrative code; 2. Guideline-based, Kidney Disease Improving Global Outcomes (KDIGO): At least 2 eGFRs/min/1.73m2 or 2 UACRs/UPCRs &gt;30 mg/g/&ge;150 mg/g &ge;90 days apart. <h6> RESULTS </h6></p><p> Overall adjusted CKD incidence rates declined over 2010-2017 by both definitions with lower rates by KDIGO (Table). By CURE-CKD, CKD incidence increased in the HTN group. <h6> CONCLUSION </h6></p><p> The practice-based CURE-CKD definition produced higher estimates of CKD incidence than the stricter guideline-based KDIGO definition. CKD incidence declined in all groups, except for HTN by the CURE-CKD definition, and was highest in patients with DM/HTN. Targeting these at-risk conditions for control may mitigate new onset CKD in these groups.</p>