Puk24 - Hyperkalaemia in Chronic Kidney Disease: Patient Treatment Experience With Renin-Angiotensin-Aldosterone- System Inhibitors in Primary Care in England

Abstract

OBJECTIVES: To evaluate the impact of the nephroprotection program through clinical data in patients with arterial hypertension and Diabetes Mellitus precursor disease of an insurer in Colombia. METHODS: From the extraction of data from the database of patients with kidney disease from a Colombian insurer, two types of analysis were carried out: Descriptive and Inferential. The descriptive analysis contains a characterization of the clinical and sociodemographic variables of the population. The inferential analysis, carried out through the statistical package Stata 14, had as a tool a methodology of comparison of means in order to verify the effectiveness of the program and the impact on the affiliated population. RESULTS: A total of 115,210 users with an average age of 68.34 years were analyzed, predominantly in females with a decrease in BMI in 61% of cases. Of the patients in the nephroprotection program, 89.6% did not present changes in the stage and only 3.3% presented regression in them. The statistical analysis showed a progression in the stages in 7.1% with a mean difference of 0.01%, which was statistically significant (p ¼ 0.000) 95% CI (0.025-0.014). In relation to precursor disease, in 60% of the patients it was Arterial Hypertension which coincides with the national statistics. In 59.6% of diabetics had HbA1c levels below 7%. In the years 2016 and 2017, 5.8% of the patients who entered the nephroprotection program had dialysis therapy, the majority (98%) in stage 5. CONCLUSIONS: It is evident that the nephroprotection program has coverage in 61% of the population with kidney disease, with good levels of control of it; with utility in the control but not in regression of the stages and with better control in the advanced stages that delay the implementation of dialysis.OBJECTIVES: Patients with Chronic Kidney Disease (CKD) taking Renin-Angiotensin-Aldosterone-System inhibitors (RAASi) are at high risk of hyperkalaemia (HK). HK can lead to RAASi treatment modification. RAASi discontinuation may lead to progression of CKD. National estimates of HK frequency and impact on CKD management are key to inform Health Authority decisions. Our objective was to describe RAASi treatment experiences and hospitalisation patterns following HK. METHODS: Retrospective cohort study of CKD (stage 3-4) patients ( 18 years old), registered in CPRD practices in England with Hospital Episode Statistic (HES) linkage. The study period was 1Jan2012-31Dec2016. CKD was defined by Read codes and lab test results. Patients had 12m data before first CKD record (index date); follow-up was until the earliest of: end of study period, last collection date, GP transfer out, death, or kidney transplant. Patients characteristics were summarized with descriptive statistics. Hospital length of stay (LOS) was estimated from HES linkage. RAASi treatment and discontinuation was defined from prescription records. RESULTS: There were 31,392 CKD patients, mostly stage 3 (n¼29,779; 94.9%) in CPRD England; mean age was 74.8 years (±12.7 SD); 42.1% w...