Kidney Week 2025 Annual Meeting-CKD: Advancing Epidemiology, Risk Factors, and Prevention

Video Transcription

Video Summary

This ASN CKD epidemiology session presented multiple real-world studies focused on kidney and cardiovascular risk prediction and prevention.<br /><br />A global cohort analysis using TriNetX compared women with preeclampsia or preexisting hypertension in pregnancy to women without hypertensive complications. Preeclampsia was strongly associated with later adverse renal outcomes, including higher incidence of CKD stage 3–5 (1.3% vs 0.1%; HR ~16), AKI, ESKD, nephrotic syndrome, nephritis, and mortality, supporting the need for structured long-term post-partum kidney follow-up and screening.<br /><br />A VA study of medication initiation among veterans with CKD found low uptake of guideline-supported therapies: only ~1 in 10 started an ACEi/ARB after CKD identification and ~1 in 16 started an SGLT2 inhibitor. Initiation was more likely with diabetes, proteinuria, higher blood pressure, and cardiovascular disease; older age predicted lower use. Black veterans were more likely to start ACEi/ARB but less likely to start SGLT2 inhibitors.<br /><br />Another VA analysis examined adherence to SGLT2 inhibitors and GLP-1 receptor agonists in diabetes. Non-adherence and discontinuation were common; women and those with CKD were at higher risk of stopping SGLT2 inhibitors, with smaller sex differences for GLP-1s.<br /><br />Using Optum claims-linked EHR, sustained ≥40% eGFR decline over three years predicted higher subsequent risks of heart failure hospitalization, MI, stroke, cardiovascular death, and kidney failure, supporting this surrogate endpoint in real-world settings.<br /><br />Other talks evaluated the AHA PREVENT risk equations in veterans with CKD, developed a urine metabolite risk score to predict CVD in Black adults with CKD (CRIC), assessed PREVENT for mortality prediction in NHANES (limited discrimination, especially in advanced CKD), proposed a dialysis vs conservative care mortality model (with methodological concerns raised), and described a CKD checklist toolkit that improved primary care confidence and self-reported practice changes.

Asset Subtitle

Moderator(s): Anna Burgner, Edgar Lerma

Presentation(s):

Preeclampsia and Long-Term Risk of CKD: Global Cohort Study Using Real-World Data - Gurwant Kaur
Differences in Early Initiation of Cardiovascular and Nephroprotective Therapies Among US Veterans with CKD - Melissa Swee
Sex Differences in SGLT2 Inhibitor and GLP-1 Receptor Agonist Discontinuation in Patients with and Without CKD - Sydney Hartsell
Association of eGFR Decline with Clinical Outcomes in Real-World US Patients with CKD - Kevin Erickson
Associations of Demographic and Clinical Comorbidities with Different PREVENT Risk Categories - Lucile Parker Gregg
A Novel Urine Metabolite Risk Score for Predicting Cardiovascular Disease in Black Adults with CKD - Changwei Li
Performance of the PREVENT Risk Score in Predicting Mortality Among Adults with CKD: Analysis of NHANES, 2005-2018 - Sundus Ali
Development and Validation of a Mortality Prediction Model for Conservative Management (CM) vs. Dialysis in Advanced CKD: Analysis of Two National Cohorts - Yoko Narasaki
Kidney Care Checklist: A Quality Improvement Initiative for Primary Practice - Krishna Vani Nemalidinne

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/8/2025

Pathway 1 CKD Non-Dialysis

Session ID 519912

Keywords

ASN CKD epidemiology

preeclampsia and chronic kidney disease risk

postpartum kidney follow-up screening

TriNetX global cohort study

veterans affairs CKD medication initiation

ACE inhibitor ARB uptake

SGLT2 inhibitor initiation disparities

medication adherence discontinuation in diabetes

GLP-1 receptor agonist adherence

sustained 40% eGFR decline surrogate endpoint

cardiovascular outcomes heart failure MI stroke

AHA PREVENT risk equations in CKD

urine metabolite risk score CRIC Black adults