2704-LB: Screening Rates and Guideline-Directed Medical Therapy Use for Chronic Kidney Disease in People with Type 2 Diabetes

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Introduction and Objective: Guideline-directed medical therapy (GDMT) improves outcomes in people with type 2 diabetes (T2D) and chronic kidney disease (CKD) but remains underused, possibly due to low CKD screening rates. This study evaluated screening and GDMT prescribing patterns in people with T2D with and without CKD.Methods: We performed a retrospective analysis of active patients in a T2D electronic health record (EHR) registry (n=34,471) at a large urban tertiary care center with a completed office visit and systolic blood pressure (SBP) recorded 2/27/2023-2/26/2026. We described rates of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) screening and GDMT use stratified by CKD, defined by ICD-10 code or an active EHR problem list diagnosis.Results: Mean age was 59 years, 55.8% were female, SBP was 133 mmHg, A1C was 7.2%, and 24.7% had CKD. eGFR and UACR were available in 52.5% and 26.6% T2D patients without CKD and 65.7% and 42.1% in T2D patients with CKD, respectively (Figure 1a). Among T2D patients, 14.7% had eGFR <60 mL/min/1.73m², 12.8% had UACR >30 mg/g, and 6.7% met criteria for high-risk CKD (CKD and UACR >30). Among CKD patients, rates of all GDMT classes were under 60% (Figure 1b & 1c).Conclusion: eGFR and UACR screening rates remain low in T2D patients with and without CKD. GDMT remains underused in CKD. Initiatives to improve rates of CKD screening and GDMT use are needed in patients with T2D.

Disclosure

S. Harrigfeld: None. L. Cunningham: Other – Grant Funding for research project through Bayer, National Kidney Foundation, and Women in Nephrology.; Current; Bayer. B. Layden: None. K. Silva: None. D.E. Smith Marsh: Other – Grant funding, Endo Advisory Board; Current; Bayer AG. Other – Editor of Merck Manual chapters.; Current; Merck & Co., Inc. Consultant; Ended; Sanofi, Novo Nordisk. C. Stepping: None. E. Van Dril: Research Support; Current; Bayer AG. A. Srivastava: Consultant; Current; CVS Health. Advisory Panel; Ended; Horizon Therapeutics plc. Consultant; Current; Novo Nordisk. Other – Grant funding; Current; Bayer AG.

Funding

Bayer, Women in Nephrology, and National Kidney Foundation (122177)



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