Kidney Week

Abstract: FR-PO338

Primary Cause of Kidney Failure in 40 Countries in Apollo Dial DB

Session Information

• Diabetic Kidney Disease: Clinical Modeling, Diagnosis, Education, and More
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 702 Diabetic Kidney Disease: Clinical

Authors

• Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States

Yue Jiao, PhD

• Wolf, Melanie, Fresenius Medical Care, Bad Homburg, Germany

Melanie Wolf

• Croft, Kaitlyn Renee, Fresenius Medical Care, Bad Homburg, Germany

Kaitlyn Renee Croft, MSc

• Carioni, Paola, Fresenius Medical Care, Crema, Italy

Paola Carioni

• Soni, Mitesh, Fresenius Medical Care, Waltham, Massachusetts, United States

Mitesh Soni

• Winter, Anke, Fresenius Medical Care, Bad Homburg, Germany

Anke Winter, MD

• Neri, Luca, Fresenius Medical Care, Crema, Italy

Luca Neri, MD, PhD

• Chaudhuri, Sheetal, Fresenius Medical Care, Waltham, Massachusetts, United States

Sheetal Chaudhuri, PhD

• Singh, Kanti, Fresenius Medical Care, Waltham, Massachusetts, United States

Kanti Singh

• Nikam, Milind, Fresenius Medical Care, Singapore, Singapore

Milind Nikam, MD, MBBS

• Stuard, Stefano, Fresenius Medical Care, Bad Homburg, Germany

Stefano Stuard, MD, PhD

• Guinsburg, Adrian M., Fresenius Medical Care, Buenos Aires, Argentina

Adrian M. Guinsburg, MD

• Chatoth, Dinesh K., Fresenius Medical Care, Waltham, Massachusetts, United States

Dinesh K. Chatoth, MD, FASN

• Hymes, Jeffrey L., Fresenius Medical Care, Waltham, Massachusetts, United States

Jeffrey L. Hymes, MD

• Koulechov, Kirill, Fresenius Medical Care, Bad Homburg, Germany

Kirill Koulechov, PhD

• Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States

Len A. Usvyat, PhD

• Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States

John W. Larkin, PhD

• Maddux, Franklin W., Fresenius Medical Care AG, Bad Homburg, Hessen, Germany

Franklin W. Maddux, MD

Background

Diabetes is a main cause of kidney failure, but the variability in rates of disease etiology is unknown. We used a global dialysis database, Apollo Dial DB, to assess the primary cause of kidney failure in 40 countries.

Methods

Apollo Dial DB is an anonymized database constructed from real-world data at a kidney care network (Fresenius Medical Care, Bad Homburg, DE). Longitudinal data is captured on an observation-level (each treatment, lab, value). First version has >360 variables (demographics, dialysis, labs, medications, surveys, & outcomes) from 01Jan2018-31Mar2021. Data anonymization was performed in alignment with recommendations from a re-identification risk determination (Privacy Analytics, Ontario, CA). We analyzed the primary cause of kidney failure defined as due to diabetes, other causes, or unspecified/unknown causes.

Results

In 543,169 adults (age ≥18 years) treated by dialysis, 455,769 (80.6%) had a known primary kidney failure cause. Globally, kidney failure due to diabetes was 39.8%, other causes were 40.8%, and unspecified/unknown cause was 19.4%). Cause of primary kidney failure varied dramatically by country ranging for: diabetes from <1% to 49%, other causes from 1% to 77%, and unspecified/unknown cause from 4% to 98% (Figure 1).

Conclusion

Leading primary cause of kidney failure is diabetes in four countries, other causes in 13 countries, and unspecified/unknown in 23 countries. Diabetic nephropathy is meaningful in select countries, but considering a global landscape, needs to be determined. The importance of other causes of kidney disease, such as hypertensive and glomerular disorders (including those in diabetes), need to be considered at a local level. The cause of kidney failure appears undetermined in many parts of the world. Findings bring to light the potential role of underdiagnosis, as well as diseases of unknown origin.

Funding

• Commercial Support – Fresenius Medical Care