Abstract: TH-PO0569
The CKD Awareness Gap: Recognition Remains Low in Underserved Primary Care Despite Growing Guidelines
Session Information
- CKD: From Global Burden to Precision Care - Epidemiology, Demographics, Geographies, and Risk Factors
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Pena Zapata, Oscar Yasser, Quinnipiac University, Bridgerport, Connecticut, United States
- Alvarez Casado, Scarlet N., Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago De Los Caballeros, Santiago Province, Dominican Republic
- Vasquez, Ana K., Pontificia Universidad Catolica Madre y Maestra Facultad de Ciencias de la Salud, Santiago De Los Caballeros, Santiago Province, Dominican Republic
- Mishra, Monika, Quinnipiac University, Bridgerport, Connecticut, United States
Background
Chronic kidney disease (CKD) affects 15% of adults in the United States and 850 million globally. Despite new therapies, CKD remains underrecognized, particularly in low-resource settings. Practice relies solely on eGFR, potentially missing patients with significant albuminuria and preserved kidney function.
Methods
A retrospective cross-sectional analysis was performed on a community-based primary care practice from August 2022 to December 2024. Patients were categorized as unrecognized CKD (meeting criteria but not enrolled in the institutional CKD registry) or confirmed CKD (enrolled in the registry). Clinical and demographic characteristics were compared between groups using t-tests and chi-square tests as appropriate.
Results
Of 6,127 patients, 545 (8.9%) met criteria for CKD. Of these, 325 (59.6%) were not in the CKD registry, and 220 (40.4%) were actively enrolled. Unrecognized CKD patients were significantly younger than those with confirmed CKD (mean age 59.5 ± 13.7 vs. 68.3 ± 14.3 years; p < 0.001), with 51.4% of unrecognized patients in the 45–64-year working-age group, compared to 31.8% of confirmed patients.
75.1% of unrecognized patients were identified solely through albuminuria (eGFR ≥ 60 and ACR ≥ 30), compared to 9.5% of confirmed CKD patients (p < 0.001).
Conclusion
In this primary care cohort, 59.6% of patients with CKD were absent from a disease registry and were nearly a decade younger than those enrolled. The critical gap was not eGFR-based recognition, but albuminuria-based identification: three-quarters of unrecognized patients had preserved eGFR and would be invisible to eGFR-only surveillance.
Systematic albuminuria screening in primary care — particularly for patients with diabetes and hypertension — could identify this population earlier and enable earlier access to medication that decreases progression.