Kidney Week

Abstract: FR-PO941

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

Session Information

• CKD Epidemiology, Risk Factors, Prevention - II
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

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

Stacey Priest,

• Guiang, Hannah A., Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States

Hannah A. Guiang,

• Johnston-Webber, Charlotte Mary, The London School of Economics and Political Science, London, London, United Kingdom

Charlotte Mary Johnston-Webber,

• Rao, Naveen, AstraZeneca PLC, Cambridge, United Kingdom

Naveen Rao,

• Chen, Jieling, AstraZeneca PLC, Cambridge, United Kingdom

Jieling Chen,

• Bhandary, Durgesh, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Durgesh Bhandary,

• Berria, Rachele, AstraZeneca Pharmaceuticals LP, Wilmington, Delaware, United States

Rachele Berria,

• Brown, Stephen, Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States

Stephen Brown,

• Grima, Daniel, Eversana Life Science Services LLC, Milwaukee, Wisconsin, United States

Daniel Grima,

• Skolnik, Neil, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States

Neil Skolnik,

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