Photo Credit: Nadezhda Buravleva
The following is a summary of “Are there lost opportunities in chronic kidney disease? A region-wide cohort study,” published in the April 2024 issue of Nephrology by Sundström et al.
Chronic kidney disease (CKD) is a long-term condition where kidneys do not work effectively, leading to waste buildup in the body, which often progresses slowly without symptoms.
Researchers conducted a retrospective study investigating early detection opportunities for CKD diagnosis and how preventing its complications could benefit the population.
They observed electronic health records (EHRs) of people between 1 Jan 2015 and 31 Dec 2020 in regions of Sweden who did not have a CKD diagnosis but had lab results suggesting CKD. These patients were later tracked to identify who was diagnosed with CKD or were prescribed medications like statins or renin-angiotensin-aldosterone system inhibitors (RAASi) and/or sodium-glucose cotransporter-2 inhibitors (SGLT2i) and who had to face severe outcomes like mortality or major adverse cardiovascular events (MACE).
The results showed that 99,382 patients were identified with undiagnosed CKD during the study period. After five years, only 33% of those received a diagnosis of CKD. The majority of the people did not get statins or RAASi, regardless of how severe their condition was. They also simulated what would happen if all these untreated people got the proper medications, and the results showed that 22% of 21,870 deaths, 27% of 14,310 cardiovascular deaths, and 39% of 22,224 MACE could have been avoided if every patient was treated with guideline-directed therapy for CKD.
Investigators concluded that not enough people are getting diagnosed with or getting treated for CKD. However, there is an ample opportunity to improve outcomes by treating CKD with early detection and the proper medications.
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