Risk Stratification Using KidneyIntelX™ Testing

Risk stratification can be used to guide treatment plans and health initiatives to prevent disease-associated complications. The bioprognostic test KidneyIntelX™ is a multiplex immunoassay of three plasma biomarkers combined with seven clinical variables to provide risk categorization (high, intermediate, or low) for progressive decline over 5 years in individuals with diabetic kidney disease (DKD).

The Wake Forest-Atrium Health System recently adopted KidneyIntelX to assess the early impact of risk categorization on management of patients with DKD.

During a poster session at the NKF Spring Clinical Meetings 2023, Richard Lord, MD, and colleagues presented results of an assessment of the distribution of KidneyIntelX risk category by self-reported race (Black vs non-Black). The poster was titled Impact of KidneyIntelX Testing on Novel Medication Prescription in a Diverse Patient Population. The researchers sought to determine the proportion initiating new antidiabetic and kidney-protective medications (sodium-glucose cotransporter-2 [SGLT2] inhibitors) by risk category and race, pre- and posttesting.

A total of 590 patients had KidneyIntelX testing between November 2021 and October 2022. Of those, median age was 67 years, 43% were men, and 32.5% were Black. Median baseline estimated glomerular filtration rate was 56 mL/min/1.73 m², median urinary albumin-creatinine ratio was 205 mg/g, and median hemoglobin A1c was 7.7%. The proportion of Black patients in the high-risk category was higher than that in the low-risk group.

Prior to KidneyIntelX testing, 13% of patients in the low-risk group, 16% in the intermediate-risk group, and 15% of those in the high-risk group were receiving SGLT2 therapy. Following up to 170 days post-test, 84% of the overall cohort had follow-up encounters. New SGLT2 inhibitor prescriptions resulted in a nearly doubling of usage to 30% of those in the intermediate-risk group and 28% of those in the high-risk group. The increase in SGLT2 inhibitor prescriptions was particularly pronounced among Black participants in the high-risk group (8.3% to 25%).

“KidneyIntelX was successfully deployed in a diverse health care system, [and] was associated with a doubling of SGLT2 inhibitor use in higher risk categories, especially in Black [patients], in accordance with guideline recommendations,” the authors said.

Source: Lord R, Houlihan J, Williams T, Coca S, Freedman B. Impact of KidneyIntelX testing on novel medication prescription in a diverse patient population. Poster #278. Abstract of a poster presented at the National Kidney Foundation Spring Clinical Meetings 2023; April 11-15, 2023; Austin, Texas. The study was supported and funded by Renalytix, plc.