The ADA DKD Prevention Model was developed to define key concepts for DKD prevention and treatment. We sought to describe and quantify specific outcome measures outlined in the ADA model following deployment of a system-wide interdisciplinary approach that centered around KidneyIntelX, a prognostic test that utilizes combines prognostic biomarkers and clinical variables to generate patient-specific risk assessment for kidney function decline. We assessed the changes in various process measures, including clinical assessments, referrals, and changes in short- and intermediate-term metrics. 6258 patients were tested with KidneyIntelX across the Mount Sinai Health System between 2021 and 2023. The median age was 67 years, with 51% females and 25% identified as African American. Baseline eGFR was 65 ml/min/1.73 m2, UACR 56 mg/g, and HbA1c 7.2%. Among tested patients scoring intermediate (40%) or high (10%) risk, UACR testing increased by 25%, NSAID prescriptions decreased by 11%, and use of SGLT2i and GLP1-RAs increased by 14-37%. Hypertension control and control of HbA1c improved by 12 to 27%, and albuminuria decreased by 19%.
In conclusion, risk assessment in patients with stages G1-3b DKD resulted in improvements in several process measures including UACR testing, guideline-recommended therapies, less nephrotoxin usage, and better control of hypertension, glycemia, and albuminuria.
J. Tokita: Research Support; Renalytix. T. McNicholas: None. G.N. Nadkarni: Stock/Shareholder; Renalytix. S. Coca: Stock/Shareholder; Renalytix. Consultant; Bayer Inc., Takeda Pharmaceutical Company Limited, 3ive Labs, Vifor Pharma Management Ltd., Boehringer-Ingelheim. M.J. Donovan: Employee; Renalytix.
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