Adherence to Chronic Kidney Disease Screening Guidelines in Type 1 and Type 2 Diabetes

Introduction and Objective: Diabetes is associated with an increased risk of chronic kidney disease (CKD), which often progresses silently, making yearly screenings of estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (uACR) recommended for early detection. This study evaluates adherence to CKD screening guidelines in individuals with type 1 (T1D) and type 2 diabetes (T2D). Methods: Newly diagnosed individuals with T1D and T2D (2015-2022) were followed through the Danish nationwide registers. The index date was the date of diabetes diagnosis. The screening date was the maximum of the date of first eGFR measurement and the date of the first uACR measurement after the index date. The time to first screening, death, or November 2023, whatever came first, was analysed with the Aalen-Johansen estimator stratified by year, sex, and diabetes type. Reported were the median time to first screening and the proportion of individuals screened within 1 year since index. Results: A total of 176,762 individuals with diabetes (168,893 T2D, 7,869 T1D) were included (median age: 61.6 years IQR: 51.1 - 72.1, 57.2 % men). The proportion of people screened for both eGFR and uACR within a year increased from 38.0% in 2015 to 48.3% in 2022, while the median time to both screenings decreased from 560 days in 2015 to 378 days in 2022. In 2022, the proportion of women screened within a year was lowest for T2D (44.9%) and highest T1D (53.8%) while for men the proportions were similar (men with T1D: 51.9%; men with T2D: 50.9%). Conclusion: While adherence to CKD screening guidelines among people with diabetes has improved over time, significant gaps remain. Targeted strategies are needed to improve adherence and ensure early detection of CKD. Disclosure: C.J. Lee: None. V. Kosjerina: None. T.A. Gerds: None. P.F. Rønn: Stock/Shareholder; Novo Nordisk A/S. P. Rossing: Speaker's Bureau; Abbott. Advisory Panel; AstraZeneca, Bayer Pharmaceuticals, Inc, Boehringer-Ingelheim, Gilead Sciences, Inc, Novo Nordisk. Other Relationship; Lexicon Pharmaceuticals, Inc. Speaker's Bureau; Daiichi Sankyo. F. Persson: Speaker's Bureau; AstraZeneca. Advisory Panel; Novo Nordisk. Speaker's Bureau; Boehringer-Ingelheim.