The magnitude of risk for chronic kidney disease (CKD) in prediabetes is unclear. The study aim was to determine CKD incidence and risk factors in patients with prediabetes from the CURE-CKD registry of electronic health record data from >2.6 million patients with or at-risk for CKD.
Adults with prediabetes were identified by established criteria for %A1C, random and fasting blood glycemia, and administrative codes. CKD was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 or urine albumin-to-creatinine ratio >30 mg/g based upon two or more measurements >90 days apart and administrative codes. Cox proportional hazards regression was used to predict incident CKD.
From 2006 to 2017, there were 544,253 patients with prediabetes and no CKD. Baseline A1C was 5.9±0.3% (mean±SD) and eGFR was 90.7±16.8 mL/min/1.73 m2. Notable medication use was: NSAIDs n=110,964 (20%), PPIs n=49,916 (9%), and ACEi/ARB n=63,738 (12%). Incident CKD occurred (n=59,583) at a rate of 25.2/1,000 person-years with mean time to CKD of 2.9 years. Older age, female gender, Hispanic/Latinx, Black, Native Hawaiian and Other Pacific Islander race/ethnicity, lower eGFR, PPI and ACEi/ARB use were associated with higher hazards of CKD in prediabetes (Table 1).
Incident CKD is common in prediabetes with risk factors similar to those in diabetes. CKD screening and detection with a focus on kidney protection may offer novel opportunities to reduce CKD risk in prediabetes.
K.A. Hennessey: None. K.B. Daratha: None. R.Z. Alicic: None. C. Jones: None. J.J. Neumiller: None. O. Duru: None. S. Nicholas: Speaker’s Bureau; Self; Janssen Pharmaceuticals, Inc. Other Relationship; Self; Centers for Disease Control and Prevention, George Institute for Global Health, Goldfinch Bio, Inc., National Institutes of Health. S.M. McPherson: None. K.C. Norris: None. K.R. Tuttle: Consultant; Self; AstraZeneca, Bayer Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Gilead Sciences, Inc., Goldfinch Bio, Novo Nordisk Inc.