Geographic disparities in CKD rate found among patients with, without type 2 diabetes
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Between 2013 and 2018, geographic disparities in the prevalence of chronic kidney disease increased in the Southeastern region of the U.S., according to data published in Kidney Medicine.
Further, increases appeared to be magnified regardless of whether patients had type 2 diabetes.
“Studies have demonstrated that the relative prevalence of CKD and type 2 diabetes is not equally distributed across the United States,” Rakesh Singh, PhD, from Bayer LLC in the U.S., and colleagues wrote. “Although these investigations have provided valuable insights into CKD and type 2 diabetes prevalence in the United States, we are not aware of any studies that have examined regional variations in the prevalence of CKD in relation to type 2 diabetes in the United States. In the current study, our primary objective was to understand differences in the prevalence of CKD (stages 1-5) with and without type 2 diabetes across the United States and variability over time.”
In a spatial and temporal comparative analysis, researchers identified patients with CKD in the U.S. using MarketScan database. The database also showed subgroups of patients with and those without type 2 diabetes.
Using geomapping, researchers created a graphic to illustrate the state-level data of CKD prevalence from 2013 to 2018. They determined geographic differences in CKD prevalence over time using univariate local indicators of spatial association.
Throughout the study period, low-low clusters, “in which a state has a low CKD prevalence, and the surrounding states have a below-average CKD prevalence,” were identified in the Northwest region. Regardless of type 2 diabetes status, the Southeast region of the U.S. showed high-high clusters of CKD in more recent years.
Researchers suggested the reasons for the increasing overall prevalence of CKD in the U.S. could include aging of the population and increased burden of risk factors, such as diabetes and hypertension.
“Regional disparities appear increasingly magnified, with a continually increasing prevalence in the Southeastern region of the United States, in contrast with a consistently lower prevalence in the Northwest region of the country, from 2013 to 2018. This finding highlights the potential need for CKD care improvement in high-prevalence states, especially because these regions also tend to have a higher prevalence of other chronic conditions that contribute to a high health care burden,” Singh and colleagues wrote. “Further exploration of the possible predictors underlying regional and temporal differences in CKD prevalence is warranted, including regional variations in commercial [vs.] Medicare distributions.”
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