Uncontrolled Diabetes, Hypertension Rates High in CKD Patients

For patients with chronic kidney disease (CKD), the prevalence of uncontrolled hypertension and diabetes is high and has not improved over time, according to a study published online in the Clinical Journal of the American Society of Nephrology.

Sri Lekha Tummalapalli, M.D., from the University of California in San Francisco, and colleagues conducted a cross-sectional study of visits to office-based ambulatory care practices for adults with diagnosed CKD from 2006 to 2014. The authors examined the change in quality performance over time.

The researchers identified 7,099 unweighted visits for patients with CKD between 2006 and 2014, representing 186,961,565 weighted visits. The prevalence of uncontrolled hypertension (>130/80 mm Hg) did not differ over time (46 percent in 2006 to 2008 versus 48 percent in 2012 to 2015; P = 0.50). In 2012 to 2014, there was a high prevalence of uncontrolled diabetes (40 percent for hemoglobin A1c >7 percent). There was a decrease in the prevalence of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use from 45 percent in 2006 to 2008 to 36 percent in 2012 to 2014; this decrease did not reach statistical significance (P = 0.072). In patients with CKD who were 50 years or older, statin use was low and remained unchanged: 29 percent in 2006 to 2008 and 31 percent in 2012 to 2014 (P = 0.92).

"Our findings indicate that, even when physicians are aware of a patient's CKD diagnosis, there are substantial gaps in quality of CKD care," the authors write.

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