#1659 Underestimate of the diagnosis and treatment of chronic kidney disease for in-hospital cardiovascular disease patients—a nationwide cross-section study in China

Abstract Underestimate of the diagnosis and treatment of chronic kidney disease for in-hospital cardiovascular disease patients—A nationwide cross-section study in China Background and Aims: Chronic kidney disease (CKD) is common and prognosis-related in patients with existing cardiovascular disease (CVD). We aim to understand the gap between clinical practice and guideline recommendations on the diagnosis and treatment of CKD in CVD patients. Method: We performed a nationwide, multicenter, cross-sectional study, enrolling CVD patients with in-hospital cardiology department records from the past year who met the CKD criteria. CKD was defined as having an estimated glomerular filtration rate (eGFR) of ≤60 mL/min/1.73 m² on two separate occasions or a urinary albumin-to-creatinine ratio (uACR) of ≥30 mg/g, with measurements taken at least three months apart. Results: From July 2023 to June 2024, 2000 eligible patients from 25 centers were enrolled. Serum creatinine was measured for all patients, while urinary albumin-to-creatinine ratio (uACR) was measured only in 400 (20%) patients during their hospital stay. The CKD diagnosis rate for the overall patient population was 54.7% (95% CI: 52.5%–56.9%). Only 40.1% of patients in Stage 3a, but 80.8% of patients in Stage 4, were diagnosed with CKD. Patients with diabetes (63.4%) and heart failure (58.9%) were more likely to be diagnosed with CKD. The usage rate of SGLT2 inhibitors (37.8% vs. 35.3%, P = 0.28) was low but similar in patients regardless of CKD diagnosis, while the use of ACEI/ARB was lower in hypertensive patients diagnosed with CKD (56.8% vs. 63.8%, P = 0.002). Additionally, traditional Chinese medicine was more likely to be prescribed to patients with a CKD diagnosis (23.86% vs. 4.42%, P < 0.001). Conclusion: The diagnosis and guideline-recommended treatment of CKD remain underestimated among CVD patients in China. Figure 1: