RWE Study: Chronic Kidney Disease often goes undiagnosed

Despite its high-risk nature and availability of kidney treatments, chronic kidney disease (CKD) often goes undiagnosed. This especially concerns patients without type 2 diabetes (T2D), who represent the majority of CKD patients. This finding comes from a recent registry study published in Nephrology Dialysis Transplantation (NDT).

CKD is a common condition in Finland, similar to T2D. The study highlights an urgent need to improve awareness and enhance risk management for CKD patients, particularly those without T2D.

The research was sponsored by pharmaceutical company AstraZeneca and involved Medaffcon experts, including Data Analysis Lead Iiro Toppila and Senior Scientific Advisor Kristiina Uusi-Rauva. 

Inclusion Criteria: Chronic Kidney Disease diagnosis and eGFR Levels

The study included primary healthcare patients from the Central Uusimaa Wellbeing Services County (Keusote) municipalities of Hyvinkää, Järvenpää, Mäntsälä, and Pornainen, as well as the city of Turku. Patients were identified based on a CKD diagnosis or their estimated glomerular filtration rate (eGFR), a key measure of kidney function assessing how well the kidneys filter blood.

“Since it was known that more patients existed beyond those already identified, additional patients were selected based on their eGFR values. Efforts were made to identify patients either through diagnosis or laboratory values,” explains Uusi-Rauva.

The impact of these study findings suggests that more efforts are needed in Finland to enhance CKD identification, with increased focus on albuminuria screening, and management, and improve the use of kidney treatments.

Regular Monitoring Recommended for Chronic Kidneys Disease Patients and Patients at Risk

National Current Care Guidelines in Finland recommend annual monitoring for patients with diabetes and CKD, while hypertensive patients should be monitored every 1–2 years. Following a CKD diagnosis, monitoring should occur at least once a year.

“While regular assessment of kidney function is recommended, it isn’t performed as frequently as it should be,” notes Uusi-Rauva.

It is known that too few patients with T2D receive regular monitoring, but insufficient data exist on the monitoring of CKD patients without diabetes or those at risk of CKD.

“It is well-known that many patients remain undiagnosed,” adds Uusi-Rauva.

CKD is one of the most common non-communicable diseases globally, posing a significant burden on healthcare systems. It is estimated to affect one in ten people worldwide. 

The prevalence of CKD and its complications is expected to rise with aging populations. Key risk factors include diabetes, hypertension, and cardiovascular diseases.

Clinical outcomes and healthcare burden

• A similar pattern of hospitalization rates was observed in patients with and without T2D.
• Cardiorenal complications (CKD or HF) contributed considerably more to the all-cause healthcare costs than the atherosclerotic CVD complications.
• Hospital care was a major cost driver, impacting costs a year before the study’s index point and remaining the primary cost contributor throughout the follow-up period.

Read more:

Characteristics, treatment and disease burden among stage 3–4 chronic kidney disease patients with and without type 2 diabetes in Finland during 2016–2022. Metsärinne K, Bodegård J, Toppila I, Uusi-Rauva K, Elmerdahl Frederiksen L, Brinkmann S. NDT (2024).

Find more RWE study summaries here.