Kidney Week

Abstract: TH-PO1007

The Prevalence of CKD in Australian Primary Care: Analysis of a National General Practice Dataset

Session Information

• CKD Epidemiology, Risk Factors, Prevention - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Jun, Min, The George Institute for Global Health, Newtown, New South Wales, Australia

Min Jun,

• Wick, James, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

James Wick,

• Neuen, Brendon Lange, The George Institute for Global Health, Newtown, New South Wales, Australia

Brendon Lange Neuen,

• Kotwal, Sradha S., The George Institute for Global Health, Newtown, New South Wales, Australia

Sradha S. Kotwal,

• Badve, Sunil, University of New South Wales, Sydney, New South Wales, Australia

Sunil Badve,

• Chalmers, John P., The George Institute for Global Health, Newtown, New South Wales, Australia

John P. Chalmers,

• Jardine, Meg, NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia

Meg Jardine,

• Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia

Vlado Perkovic,

• Gallagher, Martin P., The George Institute for Global Health, Newtown, New South Wales, Australia

Martin P. Gallagher,

• Ronksley, Paul E., University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

Paul E. Ronksley,

Background

CKD prevalence in Australia varies substantially across reports. Using a large, nationally-representative general practice data source in Australia, we determined the contemporary prevalence and staging of CKD in Australian primary care.

Methods

We performed a retrospective, community-based observational study using healthcare data from MedicineInsight, a national general practice data source in Australia. We included all adults with ≥1 visit to a general practice participating in MedicineInsight and ≥1 serum creatinine measurement (with or without a UACR measure) between 2011-2020; n=2,720,529 patients. CKD prevalence was estimated using 3 definitions: (1): an eGFR (mL/min/1.73m²) <60 or an eGFR ≥60 with a UACR (mg/mmol) >2.5 for M and >3.5 for F, (2) 2 consecutive eGFR measures <60, ≥90 days apart or an eGFR ≥60 with a UACR >2.5 for M and >3.5 for F and (3) 2 consecutive eGFR measures <60, ≥90 days part and/or 2 consecutive UACR measures >2.5 for M and >3.5 for F ≥90 days apart. Patient characteristics were assessed across the 3 definitions.

Results

CKD prevalence progressively increased over the 10-year study period, irrespective of the method used to define CKD. The annual prevalence of CKD varied across the 3 CKD definitions, with definition 1 resulting in the highest estimates. In 2020, CKD prevalence in the study cohort was 8.4% (n=123,988), 4.7% (n=69,110) and 3.1% (n=45,360) using definitions 1, 2 and 3, respectively. The number of patients with UACR measurements was low such that, among those identified as having CKD in 2020, only 3.8%, 3.2% and 1.5% respectively, had both eGFR and UACR measures available in the corresponding year. Patients in whom both eGFR and UACR measurements were available mostly had moderate or high risk of CKD progression (83.6%, 80.6% and 76.2%, respectively). Comorbid burden in patients with CKD was also frequently observed.

Conclusion

In this large, nationally-representative study, we observed an increasing trend in CKD prevalence in primary care settings in Australia. Most patients with CKD were at moderate to high risk of CKD progression with a significant comorbid burden. These findings highlight the need for early detection and effective management to slow progression of CKD.

Funding

• Commercial Support – This study was supported by an unrestricted research grant from Boehringer Ingelheim.