Chronic Kidney Disease Testing Among Primary Care Patients With Type 2 Diabetes Across 24 U.S. Health Care Organizations

© 2021 by the American Diabetes Association..

OBJECTIVE: Clinical guidelines for people with diabetes recommend chronic kidney disease (CKD) testing at least annually using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR). We aimed to understand CKD testing among people with type 2 diabetes in the U.S.

RESEARCH DESIGN AND METHODS: Electronic health record data were analyzed from 513,165 adults with type 2 diabetes receiving primary care from 24 health care organizations and 1,164 clinical practice sites. We assessed the percentage of patients with both one or more eGFRs and one or more uACRs and each test individually in the 1, 2, and 3 years ending September 2019 by health care organization and clinical practice site. Elevated albuminuria was defined as uACR ≥30 mg/g.

RESULTS: The 1-year median testing rate across organizations was 51.6% for both uACR and eGFR, 89.5% for eGFR, and 52.9% for uACR. uACR testing varied (10th-90th percentile) from 44.7 to 63.3% across organizations and from 13.3 to 75.4% across sites. Over 3 years, the median testing rate for uACR across organizations was 73.7%. Overall, the prevalence of detected elevated albuminuria was 15%. The average prevalence of detected elevated albuminuria increased linearly with uACR testing rates at sites, with estimated prevalence of 6%, 15%, and 30% at uACR testing rates of 20%, 50%, and 100%, respectively.

CONCLUSIONS: While eGFR testing rates are uniformly high among people with type 2 diabetes, testing rates for uACR are suboptimal and highly variable across and within the organizations examined. Guideline-recommended uACR testing should increase detection of CKD.

Errataetall:

CommentIn: Diabetes Care. 2022 Jan 1;45(1):e19-e20. - PMID 34986258

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:44

Enthalten in:

Diabetes care - 44(2021), 9 vom: 01. Sept., Seite 2000-2009

Sprache:

Englisch

Beteiligte Personen:

Stempniewicz, Nikita [VerfasserIn]
Vassalotti, Joseph A [VerfasserIn]
Cuddeback, John K [VerfasserIn]
Ciemins, Elizabeth [VerfasserIn]
Storfer-Isser, Amy [VerfasserIn]
Sang, Yingying [VerfasserIn]
Matsushita, Kunihiro [VerfasserIn]
Ballew, Shoshana H [VerfasserIn]
Chang, Alex R [VerfasserIn]
Levey, Andrew S [VerfasserIn]
Bailey, Robert A [VerfasserIn]
Fishman, Jesse [VerfasserIn]
Coresh, Josef [VerfasserIn]

Links:

Volltext

Themen:

AYI8EX34EU
Creatinine
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 20.10.2021

Date Revised 02.09.2022

published: Print-Electronic

figshare: 10.2337/figshare.14669748

CommentIn: Diabetes Care. 2022 Jan 1;45(1):e19-e20. - PMID 34986258

Citation Status MEDLINE

doi:

10.2337/dc20-2715

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM327799099