ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1062

Prevalence and Prognosis of CKD in Italy: The Role of Demographic Shift Towards Older Age Groups

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Ravaglia, Fiammetta, USL Toscana Centro, Florence, Italy
  • Spatoliatore, Giuseppe Lucian, USL Toscana Centro, Florence, Italy
  • Rosati, Alberto, USL Toscana Centro, Florence, Italy
  • Francesconi, Paolo, Agenzia Regionale di Sanità Toscana, Florence, Italy
Background

Prevalence of chronic kidney disease(CKD) stages 3-5 in Europe is variable(1.0-5.9%), but lower than in United States(US)(13%). In Italy, real-world data is uncertain as previous studies were limited by methodological sampling and lack of prognostic data. To address this issue, we designed a population study based on administrative data, including the elderly typically under-represented.
Objectives:to estimate CKD 3-5 stages prevalence in the resident population of a Tuscan city health unit(Empoli ASL),with sub-analysis in diabetic and hypertensive patients;to calculate the relative risk(RR) of myocardial infarction, stroke, heart failure, peripheral artery disease and death;to standardize data on the whole regional population.

Methods

All individuals referring to Empoli ASL were reviewed through the Tuscany Regional Agency for Health database. Patients>45yrs with a serum creatinine determination(SCr) in 2011-2013 by isotopic dilution mass spectrometry to estimate GFR by CKD-EPI equation were included and stratified in CKD 3a, 3b, 4-5(Renal Replacement Therapy patients excluded). Crude and standardised prevalence by sex, age and comorbidity were recorded.RR of death and cardiovascular events was assessed by Multivariate Cox analysis(controls=GFR>60ml/min).

Results

Of the 238,873 Empoli residents, 79,277(78%) were>45yrs and performed at least one SCr. 9082(11.4%) had GFR<60ml/min and 686(0.87%) had GFR<30ml/min. Age and sex distribution of CKD 3-5 showed higher prevalence in females and older age(p <0.0001)(Tab1). eGFR<60ml/min prevalence in the standardized general population>45yrs was 10.5%: stage 3a=7.1%, 3b=2.6%, 4-5=0.8%. Prevalence increased with age, in 45-74yrs group was 4.4%, in the group>85yrs: stage 3=36.5%, 4-5=4.1%(Fig1). RR of death and cardiovascular events in Tab2.

Conclusion

This is the first Italian study to evaluate CKD prevalence with a large sample (238,000 inhabitants, 6.2% Tuscany population). CKD prevalence in 45-74yrs in Tuscany resulted 4.4% (lower than US and among the lowest in Europe), however including age>45yrs it reached 10.5%, highlighting the higher prevalence in the elderly, associated with more age-related comorbidities. The comparison of CKD prevalence between Europe and US, usually based on age group 45-74yrs, underestimates the real prevalence in European countries.