KDOQI hypertension, dyslipidemia, and diabetes care guidelines and current care patterns in the United States CKD population: National Health and Nutrition Examination Survey 1999-2004

Abstract

Background/aims: National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines aim to slow chronic kidney disease (CKD) progression and reduce morbidity and mortality. This study aimed to assess current CKD population health and adherence to recommendations in National Health and Nutrition Examination Survey 1999-2004 participants aged >or=20 years (n = 14,213).

Methods: We assessed hypertension and dyslipidemia management and diabetes control, stratified by CKD status and prior history of cardiovascular disease (CVD), to ascertain awareness, treatment, and control.

Results: Hypertension was likelier among participants with than without CKD regardless of CVD history, but awareness, treatment, and control were not. Hypertensive participants with CKD were less likely than those without to be taking angiotensin-converting enzyme inhibitors or angiotensin receptor-blocking agents. Of participants with no CVD history, high cholesterol was likelier among those with CKD stages 3-4 than among those without CDK, but awareness and treatment were less likely; of participants with CVD history, high cholesterol was less likely among those with than without CKD, and awareness and treatment were as likely. Diabetes control was less likely among diabetic participants with early-stage CKD than without CKD, but not significantly different between late-stage and non-CKD participants.

Conclusions: The study timeframe coincided with or pre-dated release of KDOQI guidelines. Many opportunities for improvement in CKD patient care are evident. Future releases of NHANES data could be used to assess whether improvement occurs.