Scientists Share Latest Findings at NKF’s Annual Professional Meeting

Poster presentations shared with thousands at virtual NKF 2021 Spring Clinical Meetings 

April 8,  2021—New York, NY — Thousands of kidney disease professionals gathered virtually this week for the National Kidney Foundation’s 2021 Spring Clinical Meetings to exchange knowledge, honor the dedication of those in the community, and share cutting-edge research on kidney care.

Hundreds of poster presentations by research investigators were shared with the thousands of professionals who viewed the virtual meetings, topics included treatments that can affect transplantation, inequality in access to transplantation, and how race plays a role in the survival rates of patients with kidney disease. Hundreds of poster presentations are now online.

”What I love about our SCM poster sessions is the breadth of topics, and the creative approaches to improving care, everything from a new way to predict acute kidney injury to a better way to educate patients about kidney disease and kidney replacement therapies,” said Kerry Willis PhD, NKF’s Chief Scientific Officer. “This is how our field advances—by clinicians on the front lines trying novel approaches to solving problems they confront in their practices and telling their colleagues how they worked out. Equally important are studies that show us where we need to do better.” 

A few highlighted presentations include:

• Inside ANEMIA of CKD: microsimulation modeling of the epidemiological burden of anemia of CKD in the USA. Juan Jose Garcia Sanchez, Global Market Access and Pricing, AstraZeneca; Purav Bhatt, Global Medical Affairs Lead, AstraZeneca; and Dr. Jay Wish, Professor of Clinical Medicine, Indiana University School of Medicine, validated a microsimulation model to project the burden of anemia of chronic kidney disease (CKD) in the U.S. over the next five years. Currently, there are about 5 million patients living with anemia of stage 3a – 5 CKD, and their analysis projected this number to grow by 30 percent over the next five years. The more significant increase will be in the moderate-severe anemia of CKD group (defined by hemoglobin <11 g/dL). The model also predicts an increase in related cardiovascular complications.^[1]

“A validated epidemiologic model demonstrates that the prevalence of anemia associated with chronic kidney disease will increase by 30 percent among patients with CKD stage 3a-5 in the U.S. between 2021 and 2026,” Dr. Wish said. “This is projected to result in approximately 5 million blood transfusions which could have a negative impact on future kidney transplantation.  A national healthcare policy which encourages kidney transplantation over dialysis will also need a more proactive policy to prevent and treat anemia in this vulnerable population.”     

• Association of eGFR and Mortality by Race, with and without Use of Race Coefficient and Indexing to Body Surface Area in the CKD-EPI GFR Estimating Equation, investigators, including Jennifer Bragg-Gresham, MS, PhD^[2], Associate Research Scientist, Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, on behalf of the Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance System, found in the study that removal of the coefficient for race in the CKD-Epi eGFRestimation equation would greatly increase the proportion of Black individuals who would be considered as having Stage 3+ CKD (5.8% to 10.4%). 

The CKD-Epi eGFR equation currently indexes all eGFR estimates to a body surface area (BSA) of 1.73m². The investigators examined actual BSA of individuals in the U.S., using the National Health and Nutrition Examination Study (NHANES) and found that both Blacks and non-Blacks have a body surface area larger than 1.73m² (1.96m² and 1.91m², respectively). The investigators postulate that the indexing to 1.73m² takes away from the individual patient under consideration, particularly if they are larger or smaller in body habitus. Removal of this indexing to BSA of 1.73m², correcting the eGFR for the individual’s actual body size, attenuates much of the increase in CKD prevalence due to removal of the race coefficient. 

“The underlying reasons for lower risk of mortality in Blacks compared with non-Blacks at lower levels of kidney function is intriguing, remains unexplained, and requires further study,” Bragg-Gresham said. “Further research on developing more accurate methods of evaluating kidney damage and kidney function is vital moving forward to enable us to directly address inequities or disparities that have long existed between Black and non-Black individuals with kidney disease, supported by vigorous and systematic attention to social and environmental determinants of health.”

• ESRD Network-Level Variation in Racial/Ethnic and Sex Disparities in Renal Transplant Waitlisting. Lead investigator Reem Hamoda, MPH, MD Candidate, Pritzker School of Medicine, University of Chicago presented that previous research has long identified racial/ethnic and sex disparities in access to placement on the kidney transplant waiting list; however, few studies have examined how race and gender interact. 

“We found that compared to White men, white and Black women were 18-26 percent less likely to be placed on the waiting list for kidney transplantation even after accounting for relevant clinical and socioeconomic factors,” Hamoda said. “Additionally, we found these disparities varied considerably across the 18 end-stage renal disease (ESRD) Networks. While most Networks exhibited reduced access for women, some Networks exhibited a wider disparity for Black women compared to white women.”

These results illustrate the combined disadvantage that systemic racism and gender disparities play in reducing access to transplantation, a life-enhancing treatment option for patients with ESRD. Furthermore, the study results suggest that certain ESRD Networks may perform better than others at reducing these gaps.

“Improving access to kidney transplantation, the optimal treatment for patients with ESKD, requires an intersectional and regional approach that addresses systemic racism and gender disparities,” Hamoda said. “Despite the sobering nature of these results, we believe there is hope and opportunity.  We want all patients with ESKD to ask their providers about transplant, advocate for themselves and partner with their health care team.”

The many poster presentations are available to the participants of the Spring Clinical Meetings. View the 2021 poster gallery.

NKF Spring Clinical Meetings 

For the past 29 years, nephrology healthcare professionals from across the country have come to NKF’s Spring Clinical Meetings to learn about the newest developments related to all aspects of nephrology practice; network with colleagues; and present their research findings. The NKF Spring Clinical Meetings are designed for meaningful change in the multidisciplinary healthcare teams’ skills, performance, and patient health outcomes. It is the only conference of its kind that focuses on translating science into practice for the entire healthcare team.  This year’s Spring Clinical Meetings will be held virtually April 6-10.  

NKF Professional Membership 

Healthcare professionals can join NKF to receive access to tools and resources for both patients and professionals, discounts on professional education, and access to a network of thousands of individuals who treat patients with kidney disease. 

Kidney Disease Facts

In the United States, 37 million adults are estimated to have chronic kidney disease (CKD)—and approximately 90 percent don’t know they have it.  1 in 3 adults in the U.S. is at risk for chronic kidney disease.  Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People who are Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander are at increased risk for developing the disease. Black or African American people are almost 4 times more likely than Whites to have kidney failure. Hispanic or Latino people are 1.3 times more likely than non-Hispanic or non-Latino people to have kidney failure.

About the National Kidney Foundation

The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit www.kidney.org.

1. Incidence of cardiovascular complications, heart failure, myocardial infarction and stroke were drawn from literature sources appropriate to the US population. Patients with anemia of CKD could die from cardiovascular complications or other causes.
2. These statements are solely the responsibility of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Department of Health and Human Services.