412-P: Trends in Prevalence of Diabetic Kidney Disease in the United States

Abstract

Background: Diabetes (DM) is the leading cause of kidney disease and disproportionately affects minority populations in the U.S. We hypothesized that racial/ethnic minority adults have higher prevalence of diabetic kidney disease (DKD) than non-Hispanic White (NHW) adults, and that prevalence is increasing. Methods: Using NHANES 2011-2018 (N=3,360), we calculated weighted, age-adjusted prevalence of DKD among patients with DM. DM was defined as A1c >6.5% or use of hypoglycemic medications. DKD was defined as the presence of DM and eGFR <60ml/min per 1.73m2 or albuminuria ≥30mg/g. Results: The mean age was 59.9 years and median A1c was 7.0% (IQR 6.4, 8.1). The prevalence of DKD was 29.4% (95% CI 26.7, 32.3). Prevalence increased from 27.7% (95% CI 22.8, 32.6) to 33.1% (95% CI 28.5, 37.7) during the study (p-trend <0.0001). Compared to NHW, DKD prevalence was 1.5, 1.5, and 1.3 times higher among Mexican Americans, non-Hispanic Blacks (NHB), and non-Hispanic Asians (NHA), respectively. DKD prevalence increased for NHW, NHB, and NHA (p-trend <0.05). Among patients with HTN, 39.3% were taking an ACEi/ARB. Among those with albuminuria, 38.8% were taking an ACEi/ARB and 1.3% were taking an SGLT2i. Conclusions: Rising prevalence of albuminuric DKD and low anti-proteinuric medication use are concerning for future DKD progression. Understanding DKD trends is essential to appreciating the population-level response as new therapies are introduced. Disclosure S.E.Claudel: None. S.Waikar: None. I.M.Schmidt: None. A.Verma: None. Funding National Institutes of Health (R38HL143584)