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Abstract: TH-PO1010

Prevalence and Outcomes of CKD in England (CaReMe CKD UK)

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Zhang, Ruiqi, Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom
  • Mamza, Jil Billy, Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom
  • Gao, He, Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom
  • Lochead, Kiera C., Medical and Scientific Affairs, BioPharmaceuticals Medical, AstraZeneca, London, United Kingdom
  • Milne, Nicola, Northenden and Brooklands Primary Care Network, Manchester, United Kingdom
  • Jani, Bhautesh Dinesh, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
  • Chess, James A., Department of Nephrology, Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom
  • Sinha, Smeeta, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, United Kingdom
  • Kanumilli, Naresh, Northenden Group Practice, Manchester, United Kingdom
  • Mark, Patrick Barry, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom

Group or Team Name

  • CaReMe CKD UK.
Background

The CaReMe CKD study indicates that one in ten adults in Europe and Canada likely have chronic kidney disease (CKD). In England, 6.5% of the population has been diagnosed with CKD, but rates of possible and undiagnosed cases remain unknown. To address this, we updated the analysis with more comprehensive electronic health records (EHR) to determine the prevalence of diagnosed and potentially undiagnosed CKD and associated clinical adverse outcomes in England.

Methods

Patients were identified using linked national EHR (Clinical Practice Research Datalink, Hospital Episode Statistics and Office for National Statistics) by either having a CKD diagnosis or a single pathological value of eGFR <60 ml/min/1.73 m2 or urine albumin-creatinine ratio (UACR) ≥30 mg/g before 1st November 2020. CKD stages were defined in accordance with Kidney Disease: Improving Global Outcomes (KDIGO) criteria. CKD was categorized into three groups based on laboratory values or diagnosis codes (Figure). One year cardiovascular and renal event rates were determined using the first recorded in-hospital diagnosis at the main position.

Results

In a background population of 10,363,493, the prevalence of possible CKD was 9.2% (mean age 71, 55% women, 32% diabetes, 46% using renin-angiotensin-aldosterone system inhibitors); while one out of three did not have a corresponding CKD-specific diagnostic code, half could not be confirmed with KDIGO criteria. Prevalence of CKD was consistently higher in females across definitions. Among CKD patients confirmed by KDIGO criteria, the majority (64%) were in KDIGO stage 3A, 3% were stages one or two. Adverse events were common and 6.7%-8.7% died annually (Figure).

Conclusion

One in ten adults in England is affected by CKD, which leads to significant adverse outcomes. Diagnosis rates underestimates the actual prevalence of CKD. There is significant public health potential to identify and treat those who currently remain undiagnosed.

Prevalence, outcomes and definitions.

Funding

  • Commercial Support – AstraZeneca