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Abstract: TH-PO889

REVEAL-CKD: Management and Monitoring of Patients With CKD Stage 3 in France, Germany, Italy, Japan, and the United States

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention


  • Tangri, Navdeep, University of Manitoba Department of Internal Medicine, Winnipeg, Manitoba, Canada
  • Moriyama, Toshiki, Osaka Daigaku, Suita, Osaka, Japan
  • Schneider, Markus P., Department of Nephrology and Hypertension, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg,, Erlangen, Germany
  • Virgitti, Jean Blaise Jbv, Cabinet Medical, Orry-La-Ville, France
  • De Nicola, Luca, Department of Advanced Medical and Surgical Sciences, Nephrology and Dialysis Unit,, Naples, Italy
  • Peach, Emily J., Cardiovascular, Renal and Metabolism Epidemiology, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
  • Barone, Salvatore, Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States
  • Arnold, Matthew, Real World Evidence Data & Analytics, BioPharmaceuticals Medical, AstraZeneca, Cambridge, United Kingdom
  • Chen, Hungta (tony), Medical/Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, United States
  • Järbrink, Krister, Cardiovascular, Renal and Metabolism Evidence, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden
  • Kushner, Pam R., University of California Irvine, Irvine, California, United States

Chronic kidney disease (CKD) is vastly under-recognised yet affects 11.1% of the global population. Early diagnosis and active management can slow disease progression. This study assessed CKD management and monitoring in patients with CKD stage 3.


REVEAL-CKD is a multi-national, observational study, using medical record and claims data from the general population. Data were extracted from six databases from France, Germany, Italy, Japan, and the USA. Included patients were aged ≥18 years with 2 consecutive eGFR values ≥30 and <60 mL/min/1.73m2 recorded 91-730 days apart between 2015-2020. The date of the second qualifying eGFR was the index date. Patients with no CKD diagnosis code before and up to 6 months after index were considered undiagnosed. Data on selected quality indicators were extracted from 6-months post-index and the proportion of diagnosed and undiagnosed patients meeting these indicators was calculated.


Across the six databases cohort sizes were 20,012-250,879 patients with mean ages of 71-80 years; 41.9-52.9% were male, and median index eGFR was 49-52 mL/min/1.73m2. Prevalence of undiagnosed CKD ranged from 61.6 to 95.5%. UACR monitoring and treatment with SGLT2i was low across databases; UACR was notably 3-fold higher for patients with diagnosed CKD in Japan. Across all countries, blood pressure monitoring, and treatment with ACEi/ARB and statins was greater in patients with diagnosed CKD (Image 1).


In five countries, a large proportion of patients with CKD stage 3 are undiagnosed and do not receive timely CKD management and monitoring, however, a greater proportion of patients meet care quality indicators when they have a CKD diagnosis. There is a clear need to proactively diagnose early-stage CKD so that patients can receive guideline-directed monitoring and treatments to improve outcomes.


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