Few with type 2 diabetes receive guideline-recommended chronic kidney disease screening

Fewer than one-quarter of patients with type 2 diabetes (T2D) receive recommended chronic kidney disease (CKD) screening, according to a study published online June 26 in JAMA Network Open.

Daniel Edmonston, M.D., from the Duke University School of Medicine in Durham, North Carolina, and colleagues conducted a retrospective cohort study to examine risk factors for nonconcordance with guideline-recommended CKD screening and treatment in patients with T2D. Adults with an outpatient clinician visit linked to T2D diagnosis between Jan 1, 2015, and Dec 31, 2020, were included; concordance with CKD screening guidelines was assessed in 316,234 adults.

The researchers found that 24.9, 56.5, and 18.6% of participants received creatinine and urinary albumin-to-creatinine ratio screening, one screening measurement, and neither measurement, respectively. There was an association observed for Hispanic ethnicity with lack of screening (relative risk, 1.16).

Lower risk of nonconcordance was seen for heart failure, peripheral artery disease, and hypertension. In 4,215 patients with CKD and albuminuria, 78.0, 4.6, and 21.0% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, sodium-glucose cotransporter 2 inhibitor, or neither therapy, respectively.

Associations were seen for peripheral artery disease and lower estimated glomerular filtration rate with lack of CKD treatment; however, diuretic or statin prescription and hypertension were associated with treatment.

"These limitations in CKD screening and treatment identify areas of focus for implementation strategies to improve concordance with guideline-recommended screening and therapies for CKD," the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Boehringer Ingelheim and Eli Lilly. The study was funded by the Boehringer Ingelheim & Lilly Diabetes Alliance.

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