ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

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

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2021 and some content may be unavailable. To unlock all content for 2021, please visit the archives.

Abstract: PO2337

REVEAL-CKD: Prevalence of Undiagnosed Early CKD in France and Japan

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Virgitti, Jean Blaise Jbv, Cabinet Medical, Orry La Ville, France
  • Moriyama, Toshiki, Osaka Daigaku, Suita, Osaka, Japan
  • Wittbrodt, Eric T., AstraZeneca, Gaithersburg, Maryland, United States
  • Barone, Salvatore, AstraZeneca, Gaithersburg, Maryland, United States
  • Arnold, Matthew, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
  • Kumar, Supriya R., AstraZeneca, Gaithersburg, Maryland, United States
  • Chen, Hungta (tony), AstraZeneca, Gaithersburg, Maryland, United States
  • Järbrink, Krister, AstraZeneca, Gothenburg, Sweden
  • Tangri, Navdeep, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada
Background

Screening and monitoring of at-risk populations, such as those with type 2 diabetes (T2D), is necessary for early detection and management of chronic kidney disease (CKD). Global prevalence of undiagnosed early CKD and associated factors have not been recently studied. The objective of the REVEAL-CKD study is to assess the prevalence of undiagnosed stage 3 (S3) CKD.

Methods

REVEAL-CKD is a multi-national, multi-region secondary data study. Data for the French study cohort was extracted from THIN Cegedim (Cegedim Health Data, Boulogne-Billancourt, France) an electronic medical record (EMR) database from outpatient primary care practices. RWD database (Real World Data Co., Ltd., Kyoto, Japan) linking hospital systems’ EMR with reimbursement claims, was used for the Japanese cohort. The study population included patients aged ≥18 years between 2015-2020 with two consecutive estimated glomerular filtration rate (eGFR) readings ≥30 and <60 mL/min/1.73 m2 recorded >90 and ≤730 days apart. Undiagnosed CKD was defined as the absence of an associated CKD diagnosis code any time before 12 months prior to the first eGFR measurement and up to 6 months after the second eGFR. Presence of recorded urine albumin-to-creatinine ratio (UACR) was also assessed.

Results

After applying the eligibility criteria the study cohorts included 23,160 patients in France and 90,902 in Japan, and the proportions of patients with undiagnosed S3 CKD were 95.4% (95% confidence interval [CI] 95.1, 95.7) and 92.1% (91.9, 92.3), respectively. Prevalence in both cohorts was consistent across subgroups stratified by age (45-65, and >65 y), sex, and presence of comorbidities (T2D, HTN, and heart failure) with the exception of T2D in Japan, where undiagnosed prevalence was 82% (95% CI 81.9, 83.0). Only 2.4% of patients in the cohort in France and 5.5% in Japan had a record of a UACR value.

Conclusion

The results presented here indicate that a high proportion of early CKD patients in France and Japan are undiagnosed, with a very low frequency of UACR testing. With the advent of promising novel therapies to mitigate disease progression in patients at risk and the potential to improve patient outcomes, a clear imperative exists to highlight the importance of early CKD detection, diagnosis, and intervention.

Funding

  • Commercial Support – AstraZeneca