Trends in Attainment of the Kidney Health Evaluation for Patients With Diabetes Measure Among Insured Individuals in the US, 2021-2024
Author(s)
Stephan Dunning, MBA, MS, Douglas Londono, PhD, Yeison Ortiz, BS, Anna Wang, PhD, Nathan J. Markward, PhD, MPH, Steven Emrick, BS;
PurpleLab, Wayne, PA, USA
PurpleLab, Wayne, PA, USA
OBJECTIVES: To examine trends in attainment of Kidney Health Evaluation for Patients with Diabetes (KED) - a recent process measure, introduced in 2020 by the National Kidney Foundation (NKF) - to enhance detection and awareness of chronic kidney disease (CKD) among diabetics. Unmanaged diabetes can result in CKD progression, and related outcomes, including kidney failure and death. Results derived from these lab tests can help guide clinicians in assessing the risk of kidney failure, prescribing interventions, and transplant waitlisting.
METHODS: Using PurpleLab(R) CLEARTM Claims, we assessed annual trends from 2021-2024 for KED measure attainment among diabetics, ages 18-85, with at least one outpatient visit during the measurement year. We determined who received a full kidney health evaluation, defined by claims for both estimated glomerular filtration rate (eGFR) and quantitative urine albumin-creatinine ratio (uACR) procedures, stratifying by full, partial (i.e., either eGFR or uACR) and no attainment, during the measurement year. We then trended results overall and stratified by patient characteristics.
RESULTS: Among 16.2M, 16.7M, 17.3M and 15.8M eligible patients from 2021-2024, respectively, full KED attainment increased from 2021-2023 (23.0%, 24.2% and 26.4%, respectively), then declined slightly in 2024 to 25.1%. However, the decline may be due to incomplete claims for 2024 at the time of analysis. Lowest full KED attainment was seen among younger patients ages 18-25 (22.3% in 2023), non-Hispanic Black patients (23.8% in 2023), and those residing in the South (21.5% in 2023).
CONCLUSIONS: While full KED attainment is increasing, over 70% of diabetics are inadequately evaluated for kidney health. Additionally, the data reveal disparities in measure attainment, suggesting opportunities for health equity improvement. Consistent with prior research, we found that nearly all who receive the uACR tests achieve KED fulfillment (Ferrè et al, 2023). Further analysis could reveal how KED attainment strata is associated with related outcomes.
METHODS: Using PurpleLab(R) CLEARTM Claims, we assessed annual trends from 2021-2024 for KED measure attainment among diabetics, ages 18-85, with at least one outpatient visit during the measurement year. We determined who received a full kidney health evaluation, defined by claims for both estimated glomerular filtration rate (eGFR) and quantitative urine albumin-creatinine ratio (uACR) procedures, stratifying by full, partial (i.e., either eGFR or uACR) and no attainment, during the measurement year. We then trended results overall and stratified by patient characteristics.
RESULTS: Among 16.2M, 16.7M, 17.3M and 15.8M eligible patients from 2021-2024, respectively, full KED attainment increased from 2021-2023 (23.0%, 24.2% and 26.4%, respectively), then declined slightly in 2024 to 25.1%. However, the decline may be due to incomplete claims for 2024 at the time of analysis. Lowest full KED attainment was seen among younger patients ages 18-25 (22.3% in 2023), non-Hispanic Black patients (23.8% in 2023), and those residing in the South (21.5% in 2023).
CONCLUSIONS: While full KED attainment is increasing, over 70% of diabetics are inadequately evaluated for kidney health. Additionally, the data reveal disparities in measure attainment, suggesting opportunities for health equity improvement. Consistent with prior research, we found that nearly all who receive the uACR tests achieve KED fulfillment (Ferrè et al, 2023). Further analysis could reveal how KED attainment strata is associated with related outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD112
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Urinary/Kidney Disorders