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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


  • 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

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.


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).


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.


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.