Effect of KidneyIntelX DKD Risk Predictions on SGLT2i Prescription Rates

Researchers assessed prescription rates of sodium-glucose cotransporter 2 inhibitors (SGLT2i) among patients whose diabetic kidney disease (DKD) risk was predicted by a KidneyIntelX test versus untested patients. They will present their findings at the National Kidney Foundation Spring Clinical Meetings 2025.

KidneyIntelX is an FDA-approved test that assesses the risk of DKD progression using biomarkers and clinical variables. The test ranks patients as being at low, moderate, or high risk for a 40% decline in eGFR or kidney failure over 5 years.

The study’s test arm (NCT04802395) comprised 3,546 patients who received a KidneyIntelX test result between March 2021 and December 2022. Their DKD risk according to KidneyIntelX testing was  50.5% low, 39.9% moderate, and 9.6% high. The median baseline urine albumin-to-creatinine ratio (UACR) was 54.0 mg/g, and the median baseline estimated glomerular filtration rate (eGFR) was 63.3 mL/min/1.73 m².

The control arm consisted of 933 patients with matching intended use criteria (eGFR 30-59 mL/min/1.73 m² or eGFR ≥60 mL/min/1.73 m² and UACR >30 mg/g). The control arm had baseline encounters in the same period as the test arm but did not receive a KidneyIntelX test until 2 years later. The median baseline UACR for the control group was 65.0 mg/g, and the median baseline eGFR was 59.0 mL/min/1.73 m².

The researchers compared SGLT2i initiation rates between the 2 arms within 1 year of the baseline encounter, overall and across risk levels. Patients with KidneyIntelX test results had approximately 60% higher use of SGLT2i versus those in the control arm (30.8% vs19.2%; P<0.05).

In the test group, the increase in SGLT2i use was proportional to the risk level predicted by KidneyIntelX: low, 12.3%; moderate, 46.4%; high, 58.2% (P< 0.001 for moderate and high vs low risk). No such proportionality of SGLT2i use to future predicted risk levels was observed in the control group. “Risk assessment for DKD progression with KidneyIntelX resulted in increased and targeted use of SGLT2i by risk level for kidney health protection,” the authors concluded.

Source: Tokita J, Rathi S, Donovan M, Suarezfarinas M, Lam D. Impact of KidneyIntelX on targeted use of SGLT2i. Abstract #LB-06. Presented at the National Kidney Foundation Spring Clinical Meetings 2025; April 10-13, 2025; Boston, MA.