July 11, 2019Open Access
Trends in Quality of Care for Patients with CKD in the United States
Key Result
Between 2006 and 2014, the prevalence of uncontrolled hypertension (46% vs 48%, P=0.50) and low statin use (29% vs 31%, P=0.92) among adults with CKD remained unchanged.
Study Design
Type
Cross-Sectional (n=7,099)
Multicenter
Yes
Structured PICO
P
Population
7,099 unweighted visits (representing 186,961,565 weighted visits) for adults with diagnosed CKD in office-based ambulatory care practices between 2006 and 2014.
O
Outcome
Quality indicators including BP measurement, uncontrolled hypertension, uncontrolled diabetes, ACEi/ARB use among patients with hypertension, statin use if age ≥50 years old, and NSAID use
There are persistent, significant gaps in the quality of care for US adults with CKD, particularly regarding blood pressure control, diabetes management, and statin utilization.
Main Result
Absolute Event Rate: 48% vs 46%
p-value: p=0.50
Abstract
Background and objectives Improving the quality of CKD care has important public health implications to delay disease progression and prevent ESKD. National trends of the quality of CKD care are not well established. Furthermore, it is unknown whether gaps in quality of care are due to lack of physician awareness of CKD status of patients or other factors. Design, setting, participants, P =0.50). There was a high prevalence of uncontrolled diabetes in 2012–2014 (40% for hemoglobin A1c >7%). The prevalence of ACEi/ARB use decreased from 45% in 2006–2008 to 36% in 2012–2014, which did not reach statistical significance ( P =0.07). Statin use in patients with CKD who were 50 years or older was low and remained unchanged from 29% in 2006–2008 to 31% in 2012–2014 ( P =0.92). Conclusions In a nationally representative dataset, we found that patients with CKD had a high prevalence of uncontrolled hypertension and diabetes and a low use of statins that did not improve over time and was not concordant with guidelines.