BACKGROUND

Hypertension (HTN), diabetes mellitus (DM), and prediabetes (PDM) are major risk factors for chronic kidney disease (CKD), yet community-level longitudinal studies of CKD incidence are lacking. The study aim was to determine CKD incidence rates in these at-risk groups by practice- and guideline-based definitions. METHODS

The Center for Kidney Disease Research, Education, and Hope (CURE-CKD) registry is curated from electronic health records with clinical and administrative data from two large non-profit healthcare systems. CKD incidence (95% CI) in adults was calculated over 4, two-year time periods during 2010-2017 adjusted for age, sex, and race/ethnicity. CKD was identified by 2 definitions: 1. Practice-based, CURE-CKD: At least 2 laboratory measures for CKD ≥90 days apart (estimated glomerular filtration rate - eGFR/min/1.73m2, urine albumin/creatinine ratio - UACR ≥30 mg/g, or urine protein/creatinine ratio - UPCR ≥150 mg/g) or CKD administrative code; 2. Guideline-based, Kidney Disease Improving Global Outcomes (KDIGO): At least 2 eGFRs/min/1.73m2 or 2 UACRs/UPCRs >30 mg/g/≥150 mg/g ≥90 days apart. RESULTS

Overall adjusted CKD incidence rates declined over 2010-2017 by both definitions with lower rates by KDIGO (Table). By CURE-CKD, CKD incidence increased in the HTN group. CONCLUSION

The practice-based CURE-CKD definition produced higher estimates of CKD incidence than the stricter guideline-based KDIGO definition. CKD incidence declined in all groups, except for HTN by the CURE-CKD definition, and was highest in patients with DM/HTN. Targeting these at-risk conditions for control may mitigate new onset CKD in these groups.