Kidney Week

Abstract: SA-PO1206

"The Silent Killer": Clinical Consequences of Undiagnosed CKD

Session Information

• CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Levin Iaina, Nomy, Barzilai Medical Center, Ashkelon, South District, Israel

Nomy Levin Iaina, MD

• Habbashe, Nayef Mohamed, Emek Medical Center, Afula, North District, Israel

Nayef Mohamed Habbashe, MD

• Abu Akel, Shaden, Ben-Gurion University of the Negev Faculty of Health Sciences, Be'er Sheva, South District, Israel

Shaden Abu Akel, MD, MPH

• Reiner-Benaim, Anat, Ben-Gurion University of the Negev Faculty of Health Sciences, Be'er Sheva, South District, Israel

Anat Reiner-Benaim, PhD

Background

CKD is common and linked to increased morbidity and mortality. Despite its impact, CKD often remains undiagnosed, limiting timely intervention. This study examined kidney, cardiovascular and mortality outcomes among patients with and without a documented CKD diagnosis.

Methods

Data from Clalit Health Services (2000–2023) were analyzed. CKD was defined by eGFR below 60mL/min/1.73m2 and/or UACR above 30mg/g in at leas two measurements. Patients were categorized by the presence or absence of a documented CKD diagnosis

Results

Among 640,217 patients with lab-confirmed CKD, 56.2% were undiagnosed. These patients were more often women, Arabs, and Orthodox Jews, with milder CKD and lower rates of diabetes, hypertension, and cardiovascular conditions. Undiagnosed patients received fewer treatments, including markedly lower use of SGLT2i. Despite appearing healthier at baseline, undiagnosed patients had faster progression to dialysis, and earlier cardiovascular events and death. Treatment with SGLT2i was associated with a 70% reduction in the combined risk of dialysis and mortality, and a 45% reduction in major CVS events

Conclusion

More than half of patients with CKD remain undiagnosed, missing the chance for early intervention. The consequences are substantial, contributing to earlier renal failure, cardiovascular burden, and premature death. These findings highlight the urgent need for systematic screening and increased clinician awareness

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025p2xa4nda