Visual Abstract
Background: Effective actions to slow chronic kidney disease (CKD) progression depend on early disease recognition. This study aimed to assess the prevalence of and factors associated with undiagnosed stage 3 CKD.
Methods: REVEAL-CKD is a multinational initiative to assess undiagnosed CKD. From the US, we utilised TriNetX, a federated research network providing statistics on electronic health records. Adult patients, with two eGFR measurements ≥30 and <60 mL/min/1.732 at least 90 days apart, were identified between 2015-2020. The date of the second eGFR measurement was defined as the index date. Those with no CKD diagnosis code at any time before or up to 6 months after the index date were considered to have undiagnosed CKD.
Results: The study cohort included 178,331 patients whose mean age at index date was 70.8 years (standard deviation (SD): 10.6). The proportion of patients with undiagnosed CKD was 62.4% (95% confidence interval [CI] 62.2 to 62.6). Patients with comorbidities or younger age had a lower undiagnosed rate (Table 1). Of 123,994 patients with undiagnosed CKD at the index date, 25% received a diagnosis at some point during follow-up, with a median time to diagnosis of 253 days.
Conclusion: This study documented that a majority of stage 3 CKD patients were undiagnosed. These results suggest that an opportunity exists for more proactive CKD diagnosis and monitoring at early stages.
A. Abdul sultan: Employee; Self; AstraZeneca. S. Barone: Employee; Self; AstraZeneca. S. Kumar: Employee; Self; AstraZeneca, Stock/Shareholder; Self; AstraZeneca. H. Chen: None. K. Järbrink: Employee; Self; AstraZeneca. E. T. Wittbrodt: Employee; Self; AstraZeneca, Stock/Shareholder; Self; AstraZeneca. P. R. Kushner: Advisory Panel; Self; Abbott Diabetes, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk, Speaker’s Bureau; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk.