Treatment of CKD, Hospitalizations, and Costs in an Incident CKD Population: A Multicentric Real-World Study

Speaker(s)

Cunha C1, Filipe R2, Paiva P2, Oliveira JM2, Correia JS3, Baldo MJ3, Dias J3, Tomé E4, Reis A4, Rodrigues F4, Lavadinho I5, Colunas P5, Viegas M5, Silva G6, Drummond M6, Lopes R7, Pardal M8, Couceiro J9, Pedroso D10, Bernardo F9
1Matosinhos Local Health Unit, Porto, Porto, Portugal, 2Castelo Branco Local Health Unit, Castelo Branco, Castelo Branco, Portugal, 3Guarda Local Health Unit, Guarda, Guarda, Portugal, 4Nordeste Local Health Unit, Bragança, Bragança, Portugal, 5Norte Alentejano Local Health Unit, Portalegre, Portalegre, Portugal, 6RAM Primary Health Service, Funchal, Funchal, Portugal, 7MTG Research and Development Lab, Porto, Porto, Portugal, 8AstraZeneca Portugal, Barcarena, 11, Portugal, 9AstraZeneca Portugal, Barcarena, Lisboa, Portugal, 10AstraZeneca Portugal, Lamego, Portugal

Presentation Documents

OBJECTIVES: RAASi & SGLT2i effectiveness for CKD progression & outcomes is proven, but real-world data on treatment patterns and costs is needed to optimize CKD management. This study describes outcomes and costs in newly diagnosed CKD patients in Portugal based on treatment patterns after one year.

METHODS: Multicentric, retrospective study using secondary data from HER of adult CKD patients diagnosed 2016-2022 with 1 year follow-up. CKD diagnosis was confirmed by ICD-9/ICD-10/ICPC-2 diagnosis codes for CKD or biochemical confirmation (at least 1 UACR measure of ≥30 mg/g OR at least 2 eGFR measures ≥ 90 days apart, of which the second eGFR is ≤75 ml/min/1.73m2). Kidney-protective treatment use (RAASi/dapagliflozin) was assessed at diagnosis and follow-up in overall CKD cohort and in subgroups with or without type 2 diabetes (T2D). Measures of outcomes and costs were assessed for treated and untreated CKD patients one year after diagnosis. Descriptive analyses were performed.

RESULTS: In this preliminary analysis, 34 607 incident CKD cases (56% female, mean age 70, mean BMI of 28 kg/m2) were identified. Most prevalent comorbidities: hypertension (93%), T2D (22%), atherosclerotic disease (20%) and heart failure (12%). KDIGO GFR distribution: Most patients were G2 (62%), followed by G3a (15%) and G3b (6%). Albuminuria distribution: A1 was most common (67%), followed by A2 (29%) and A3 (4%). Majority (50%) of patients presented low risk, followed by 36%, 9% and 5% of moderate, high and very high risk respectively. Prior RAASi use was high (83%), while SGLT2i use was low (3%). Follow-up outcomes showed 1% mortality, 59% hospitalization, and 8% CKD hospitalization. Further analysis of outcomes and costs based on treatment exposure are ongoing.

CONCLUSIONS: This study evidence the high incidence of CKD, underlining the need for early diagnosis. There is an opportunity to maintain/initiate kidney-protective treatment towards prevention of outcomes and related costs decrease in CKD.

Code

RWD43

Topic

Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health, Study Approaches

Topic Subcategory

Clinician Reported Outcomes, Electronic Medical & Health Records

Disease

Drugs, Urinary/Kidney Disorders