Use of Kidney-Protective Therapies in a Diverse CKD Cohort: Baseline Data from Columbia University Irving Medical Center

Background: Racial and socioeconomic disparities in chronic kidney disease (CKD) care persist, particularly in the prescription of guideline-recommended medications in the new international guidelines. We describe the demographic and clinical characteristics of CKD patients seen at Columbia University Irving Medical Center (CUIMC) to identify baseline prescribing patterns and inform future interventions. Methods: We retrospectively analyzed adults with CKD seen at four CUIMC nephrology clinics in 2024. CKD was defined as eGFR 20–59 or eGFR 20–90 with albuminuria >30 mg/g or trace protein. Demographics, comorbidities, labs, and prescriptions for ACEis, ARBs, SGLT2is, and MRAs were extracted from the EHR. Descriptive statistics were conducted using STATA 19. Results: Among 3,874 eligible patients, the average age was 70 years, and 46% were female. Ethnically, 35.9% identified as Hispanic, and racially, 19.2% identified as Black or African American. Medicaid was the primary insurance for 12%, and over one-third reported a non-English primary language. Diabetes (42.6%) and congestive heart failure (10.4%) were among the most common comorbidities. CKD stages 2, 3a, 3b, and 4 accounted for 10.9%, 35%, 37%, and 17.0% of the cohort, respectively. Prescription rates for kidney-protective medications were 55% for ACEi/ARBs, 30% for SGLT2is, and 14% for MRAs. Of those prescribed MRAs, 83.2% received steroidal MRAs and 16.8% received non-steroidal agents. Conclusion: This analysis reveals substantial underutilization of kidney-protective medications in a diverse CKD population, underscoring the need to better characterize patients at risk for suboptimal treatment. Understanding sociodemographic variations in prescribing patterns is essential to designing targeted interventions that promote pharmacoequity in CKD care. We plan to conduct further analysis to better understand sociodemographic variations in prescribing patterns, with the goal of informing targeted interventions that promote pharmacoequity in CKD care Funding: This study was supported by an investigator grant from Bayer US LLC. No additional disclosures for the listed authors are applicable. Funding: Commercial Support - Bayer US LLC