Clinical Characteristics of and Risk Factors for Chronic Kidney Disease Among Adults and Children
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Key Points
To describe clinical features, prevalence, major risk factors, and clinical care patterns among adults and children with or at risk for chronic kidney disease across two large US health care systems.
Retrospective cohort study using the CURE-CKD registry comprising electronic health record data from Providence St Joseph Health and UCLA between January 2006 and December 2017.
Included 2,625,963 pediatric and adult patients with chronic kidney disease (excluding end-stage kidney disease) or at risk of disease due to diabetes, hypertension, or prediabetes.
Assessed kidney function via estimated glomerular filtration rate, proteinuria/albuminuria testing, and documented exposures to protective and nephrotoxic medications.
Adult chronic kidney disease prevalence rose significantly over time from 1.6% (93,644/6,011,129) in 2006-2009 to 5.7% (393,455/6,903,084) in 2010-2013 and 8.4% (683,574/8,179,860) in 2014-2017 (P < .001).
Among 606,064 adults with chronic kidney disease, screening was low (8.7% assessed for albuminuria and 4.1% for proteinuria), only 20.6% received a renin-angiotensin system inhibitor, and 33.7% received potentially nephrotoxic medications.
Of 1,973,258 at-risk adults, 48.4% had hypertension alone, 26.0% had diabetes or prediabetes alone, and 25.6% had both hypertension and diabetes or prediabetes.
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Implication
Cohort study reveals rising prevalence and suboptimal care of chronic kidney disease in US patients, indicating a need for improved management.