12-LB: Clinical Impact of Risk Profiling with KidneyIntelX on DKD Progression in a Large Integrated Health Care System

JOJI TOKITA, Catherine Sinfield,MICHAEL J. DONOVAN, T. A. McNicholas,Michael W. Kattan,David W. Lam

Diabetes(2023)

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摘要
KidneyIntelXTM combines 3 plasma biomarkers with clinical variables to categorize adults with DKD stages 1-3b for risk of a progressive decline in kidney function over 5 years. We previously demonstrated that using KidneyIntelX to assess risk and guide treatment does lead to optimized medication use, lifestyle changes, and specialist referrals. We now report the one-year pre and posttest clinical impact on eGFR slope and hemoglobin A1C (HbA1c) in the Mount Sinai Health System. Among the 1087 patients with follow-up data, the median age was 69 years, 52% were women, 32% self-identified Black, baseline eGFR 59 ml/min/1.73m2, baseline HbA1c was 7.2%, and 146 (13%), 439 (40%), and 502 (46%) were scored as high, intermediate, and low risk by KidneyIntelX. In high-risk patients, median eGFR slope slowed from -5.7 ml/min/year pre-test to -2.1 ml/min/year post-test (p<0.001), and from -1.8 ml/min/year to -1.0 ml/min/year in intermediate-risk (p=0.005) (Table). The median HbA1c decreased from 8.4 to 7.7% (p<0.001) in high risk, and from 7.5 to 7.2% (p<0.001) in intermediate risk. In conclusion, deployment and risk stratification by KidneyIntelX was associated with reduced rate of kidney function decline and improved glycemic control, particularly in those scored as high risk. Disclosure J. Tokita: Other Relationship; Renalytix. C. Sinfield: None. M. J. Donovan: Employee; Renalytix. T. McNicholas: Employee; Renalytix. M. Kattan: Research Support; Novo Nordisk. Consultant; Renalytix, Verici. Research Support; Bayer Inc. D. W. Lam: None.
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关键词
kidneyintelx,dkd progression,risk profiling,clinical impact
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