Incident chronic kidney disease: Trends in management and outcomes

Robert M. Perkins, Alex R. Chang, Kenneth E. Wood, Josef Coresh, Kunihiro Matsushita, Morgan Grams

Research output: Contribution to journalArticle

Abstract

Background: Management trends in early chronic kidney disease (CKD) and their associations with clinical outcomes have not previously been reported. Methods: We evaluated incident (Stage G3A) CKD patients from an integrated health care system in 2004-06, 2007-09 and 2010-12 to determine adjusted trends in screening (urinary protein quantification), treatment [prescription for angiotensinconverting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB), and statin] and nephrology referral. For the same time periods, adjusted rates for mortality, progression to Stage G4 CKD and hospitalization for myocardial infarction or heart failure were calculated and compared across time periods. Results: There were 728, 788 and 956 patients with incident CKD in 2004-06, 2007-09 and 2010-12, respectively. Adjusted rates of proteinuria quantification (31, 39 and 51 screens/100 person-years), statin prescription (53, 63 and 64 prescriptions/100 person-years) and nephrology referral (2, 3 and 5 referrals/100 person-years) all increased over time (P for trend 0.4 in all cases). Conclusion: In this integrated health care system, management of incident CKD over the past decade has intensified.

Original languageEnglish (US)
Pages (from-to)432-437
Number of pages6
JournalClinical Kidney Journal
Volume9
Issue number3
DOIs
StatePublished - 2016

Keywords

  • cardiovascular
  • Chronic renal insufficiency
  • Epidemiology
  • Proteinuria
  • Renin-angiotensin system

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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