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Abstract: FR-PO941

IMPACT CKD: Projecting the Growing Environmental Burden of CKD in the United States

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Priest, Stacey, Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States
  • Guiang, Hannah A., Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States
  • Johnston-Webber, Charlotte Mary, The London School of Economics and Political Science, London, London, United Kingdom
  • Rao, Naveen, AstraZeneca PLC, Cambridge, United Kingdom
  • Chen, Jieling, AstraZeneca PLC, Cambridge, United Kingdom
  • Bhandary, Durgesh, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Berria, Rachele, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States
  • Brown, Stephen, Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States
  • Grima, Daniel, Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States
  • Skolnik, Neil, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
Background

Chronic kidney disease (CKD) is a significant source of morbidity and mortality with substantial costs associated with renal replacement therapy (RRT) (including dialysis and transplantation). However, it is imperative to understand the wider impact of CKD, including its societal and environmental consequences, to inform healthcare planning and policy development. This study aims to comprehensively quantify the burden of CKD in the United States (US).

Methods

A patient-level simulation model, IMPACT CKD, was developed to simulate the natural history of CKD progression while incorporating the impact of acute kidney injury, cardiovascular events and comorbidities. CKD status was assigned using estimated glomerular filtration rate (eGFR) and albuminuria levels, and clinical progression was predicted by annual eGFR decline rate. The model was used to forecast the 10-year impact of CKD on environment in the US in addition to clinical, economic, and societal outcomes. The model was validated and calibrated for the US setting.

Results

While CKD prevalence is predicted to remain steady from 2022 to 2032 (17%), the number of patients increases from 57 to 60 million. The projected distribution of CKD stages includes 38% in stage 1, 19% in stage 2, 34% in stage 3, 5% in stage 4, and 4% in stage 5 (including RRT) in 2032. Substantial increases are observed in stage 3 to pre-RRT stage 5 (14.5%) and the number of patients receiving RRT is expected to rise by 48% (882,026 to 1,303,141). Alongside the escalating clinical burden, CKD and RRT are poised to exert detrimental environmental impacts. Freshwater consumption, fossil fuel depletion, and CO2 emissions associated with CKD and RRT are estimated to rise by 26%, 26%, and 37% respectively, from 2022 to 2032. RRT accounts for the most substantial environmental burden, with projected contributions of 1.9 billion m3 of freshwater consumption, 26.9 billion kg of fossil fuel depletion, and 64.9 billion kg of CO2 emissions over the next decade.

Conclusion

The IMPACT CKD model highlights the enduring burden of CKD in the US. With projected high prevalence and environmental burdens, improved management strategies mitigating the substantial environmental impact of CKD and RRT are vital for a healthier future.

Funding

  • Commercial Support – AstraZeneca