Fewer than one-quarter of patients with type 2 diabetes (T2D) receive recommended chronic kidney disease (CKD) screening, according to a study in JAMA Network Open. A team of researchers conducted a retrospective cohort study to examine risk factors for nonconcordance with guideline-recommended CKD screening and treatment in patients with T2D. Adults with an outpatient clinician visit linked to T2D diagnosis between January 1, 2015, and December 31, 2020, were included; concordance with CKD screening guidelines was assessed in 316,234 adults. The study team found that 24.9%, 56.5%, and 18.6% of participants received creatinine and urinary albumin-to-creatinine ratio screening, one screening measurement, and neither measurement, respectively. The study team observed an association between Hispanic ethnicity and lack of screening (relative risk, 1.16). A lower risk of nonconcordance was seen for heart failure, peripheral artery disease, and hypertension. In 4,215 patients with CKD and albuminuria, 78.0%, 4.6%, and 21.0% received an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, sodium-glucose cotransporter 2 inhibitor, or neither therapy, respectively. Associations were seen for peripheral artery disease and lower estimated glomerular filtration rate with lack of CKD treatment; however, diuretic or statin prescription and hypertension were associated with treatment.
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