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. 2021 Mar 12;14(10):2246-2254.
doi: 10.1093/ckj/sfab055. eCollection 2021 Oct.

Unmet needs for CKD care: from the general population to the CKD clinics-how many patients are we missing?

Massimo Torreggiani  1 , Antoine Chatrenet  1 , Antioco Fois  1 , Jean Philippe Coindre  1 , Romain Crochette  1 , Mickael Sigogne  1 , Samuel Wacrenier  1 , Guillaume Seret  2 , Béatrice Mazé  1 , Léna Lecointre  3 , Conrad Breuer  3 , Hafedh Fessi  4 , Giorgina Barbara Piccoli  1   5
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Unmet needs for CKD care: from the general population to the CKD clinics-how many patients are we missing?

Massimo Torreggiani et al. Clin Kidney J. .

Abstract

Introduction: Prevalence of chronic kidney disease (CKD) varies around the world. Little is known about the discrepancy between the general population's needs and nephrology care offered. We aimed to contribute to filling this gap and propose a means to infer the number of patients needing follow-up.

Methods: All patients undergoing at least one nephrology consultation in 2019 were enrolled. We used the ratio between CKD Stages 3 and 4 reported in the literature, and considered that only 25-50% of CKD Stage 3 patients have progressive CKD, to hypothesize different scenarios to estimate the number of CKD Stage 3 patients still needing nephrology follow-up.

Results: The 1992 CKD patients were followed-up in our centre (56.93% males; age 66.71 ± 18.32 years; 16.82% Stage 1; 14.66% Stage 2; 39.46% Stage 3; 19.88% Stage 4; 7.68% Stage 5). The ratio between Stages 3 and 4 in population studies ranged from 7.72 to 51.29, being 1.98 in our centre. Hypothesizing that we followed-up 100, 70 or 50% of CKD Stage 4 patients, 528-2506 CKD Stage 3 patients in our area would need nephrology follow-up [1885-8946 per million population (p.m.p.)]. Three to 17 additional nephrologists p.m.p. would be necessary to fully cover the need for care.

Conclusions: The number of patients with CKD Stage 3 who would benefit from nephrology care is high. Considering that one patient-year of delay of dialysis could cover a nephrologist's annual salary, interventions aimed to improve the care of advanced CKD may be economically sound.

Keywords: CKD stages; chronic kidney disease; epidemiology; healthcare policies; nephrology care.

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Figures

None
Graphical abstract
FIGURE 1:
FIGURE 1:
CKD Stage 4 prevalence in Europe. Prevalence is expressed on a colour scale; the black area represents the Sarthe region.
FIGURE 2:
FIGURE 2:
CKD Stages 3–4 ratio in Europe. Prevalence is expressed on a colour scale; the black area represents the Sarthe region.
See this image and copyright information in PMC

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