Abstract: TH-PO1045
Management Patterns of CKD in Japanese Primary Care: Findings from a Nationwide Survey of General Practitioners Using the JAMDAS Database
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Imaizumi, Takahiro, Nagoya Daigaku, Nagoya, Aichi Prefecture, Japan
- Asada, Shinji, Kyowa Kirin Kabushiki Kaisha, Chiyoda, Tokyo, Japan
- Kanai, Sumire, Kyowa Kirin Kabushiki Kaisha, Chiyoda, Tokyo, Japan
- Araki, Shin-ichi, Wakayama Kenritsu Ika Daigaku, Wakayama, Wakayama Prefecture, Japan
Background
The prevalence of chronic kidney disease (CKD) continues to rise worldwide. Despite Japan’s excellent healthcare access, CKD management challenges persist. While clinical practices among nephrologists are well-documented, limited research exists on CKD management in primary care settings. We aimed to characterise Japanese primary care physicians' CKD clinical practice patterns.
Methods
We used the JAMDAS database, collecting data from Japanese general practitioners through electronic health records. We enrolled patients ≥18 years regularly attending clinics who received antihypertensive or antidiabetic medications more than twice a year (Jan-Dec 2024), excluding those on replacement therapy.
Results
Among 859,044 eligible patients (mean age 70 years, 51% female) from 20,188,033 records, eGFR, serum potassium, dipstick proteinuria, and hemoglobin were measured in 76%, 63%, 11%, and 70% of patients, respectively. Urinary testing decreased with age (Figure 1). Of the 3.3% receiving anemia treatment, 85% used iron preparations, 8% erythropoiesis-stimulating agents (ESAs), and 16% hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs). Among anemia-tested patients, ferritin, transferrin saturation, and serum iron measurement were 5%, 0.4%, and 15%. Of 5,219 patients with coded renal anemia and hemoglobin measurement, 74% received ESAs/HIF-PHIs. Approximately 60% of patients with hemoglobin levels ≥13 g/dL still received ESAs/HIF-PHIs (Table 1).
Conclusion
CKD patients in primary care settings rarely underwent urinalysis (11%), with rates declining with age. ESAs/HIF-PHIs were frequently continued in patients with hemoglobin ≥ 13 g/dL, while iron kinetics evaluation remains inadequate. These findings indicate a need for targeted CKD education for primary care physicians.
Prescription of ESA or HIF-PHI across hemoglobin levels
| < 10 g/dL (n=1,126) | 10 ≤, < 13 g/dL (n=3,540) | ≥ 13 g/dL (n=553) | |
| ESA or HIF-PHI treated | 943 (84%) | 2,590 (73%) | 324 (59%) |
Funding
- Commercial Support – Kyowa Kirin Company