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. 2024 May 2:72:102614.
doi: 10.1016/j.eclinm.2024.102614. eCollection 2024 Jun.

Projecting the clinical burden of chronic kidney disease at the patient level (Inside CKD): a microsimulation modelling study

Glenn M Chertow  1 , Ricardo Correa-Rotter  2 , Kai-Uwe Eckardt  3 , Eiichiro Kanda  4 , Avraham Karasik  5 , Guisen Li  6 , Christian Fynbo Christiansen  7 , Panos Stafylas  8 , Stephen G Holt  9 , Ernst C Hagen  10 , Juan Jose Garcia Sanchez  11 , Salvatore Barone  12 , Claudia Cabrera  13 , Stephen Nolan  14 , Timothy Coker  15 , Laura Webber  15 , Lise Retat  15
Affiliations

Projecting the clinical burden of chronic kidney disease at the patient level (Inside CKD): a microsimulation modelling study

Glenn M Chertow et al. EClinicalMedicine. .

Abstract

Background: Chronic kidney disease (CKD) is a global concern that presents significant challenges for disease management. Several factors drive CKD prevalence, including primary risk factors, such as type 2 diabetes and hypertension, and an ageing population. Inside CKD is an international initiative that aims to raise awareness of the substantial burden incurred by CKD.

Methods: Using a peer-reviewed microsimulation method, the clinical burden of CKD was estimated from 2022 to 2027. Demographic data from the Americas, Europe, and Asia-Pacific/Middle East were used to generate virtual populations and to project the prevalence of CKD, kidney replacement therapy, associated cardiovascular complications, comorbid conditions, and all-cause mortality in the CKD population over the modelled time frame.

Findings: Across the 31 participating countries/regions, the total prevalence of CKD was projected to rise to 436.6 million cases by 2027 (an increase of 5.8% from 2022), with most cases (∼80%) undiagnosed. Inside CKD projected a mean of 8859 cases of heart failure, 10,244 of myocardial infarction, and 7797 of stroke per 100,000 patients with CKD by 2027.

Interpretation: The clinical impact of CKD is substantial and likely to increase; the high prevalence of undiagnosed cases and associated complications may benefit from the implementation of health policy interventions that promote screening, earlier diagnosis, and interventions to improve outcomes.

Funding: AstraZeneca.

Keywords: Burden of disease; Chronic kidney disease; Epidemiology; Microsimulation; Policy.

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Conflict of interest statement

AK has received honoraria for lectures from AstraZeneca. ECH, GL, EK, CFC and RCR have received support from AstraZeneca for their contributions to this work. Stanford University School of Medicine has received grants/contracts from NIDDK, NIAID and CSL Behring on behalf of work conducted by GMC. GMC has received consulting fees from AstraZeneca, Akebia, Ardelyx, Renibus, Miromatrix, Sanifit, Unicycive and Vertex. GMC has received royalties/licences from Elsevier. GMC has participated in advisory boards/data safety monitoring boards by Bayer, Mineralys and ReCor. GMC has a leadership/fiduciary role with Satellite Healthcare Board of Directors (which is non-profit). GMC has stock/stock options at Applaud, CloudCath, Durect, Eliaz Therapeutics, Miromatrix, Outset, Renibus and Unicycive. K-UE has received grants from AstraZeneca, Amgen, Bayer, Evotec and Vifor. K-UE has received consulting fees from Akebia, AstraZeneca, Bayer, Otsuka and Retrophin. K-UE has received honoraria/payment for lectures by AstraZeneca and Bayer. K-UE has participated in advisory boards/data safety monitoring boards by AstraZeneca. LR, LW and TC are employees of HealthLumen Ltd, and AstraZeneca provided funding to HealthLumen Ltd for their contributions to this work. HealThink received funding from AstraZeneca based on the contributions of PS to this work. RCR has received grants/contracts from AstraZeneca. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán has received grants/contracts from Boehringer Ingelheim, Novo Nordisk, Roche and Baxter on behalf of work conducted by RCR. RCR has received consulting feeds from Chinook, Boehringer, Bayer and Medxl. RCR has received honoraria/payment for lectures by AstraZeneca, Amgen, Boehringer, Novo Nordisk and Bayer. SEHA Kidney Care received honoraria payments from AstraZeneca for the contributions of SGH to this work. JJGS, SB, CC and SN are employees and shareholders of AstraZeneca.

Figures

Fig. 1
Fig. 1
Overview of the microsimulation modules. CKD = chronic kidney disease. CV = cardiovascular. eGFR = estimated glomerular filtration rate. KRT = kidney replacement therapy.
Fig. 2
Fig. 2
Projected percentage change of CKD prevalence in each population 2022–2027. Notes: The UAE has a large and diverse Expatriate population with a different CKD profile; only the Emirati population has been presented here. CKD = chronic kidney disease.
Fig. 3
Fig. 3
Projected cumulative incidence (2022–2027) of cardiovascular complications in patients with diagnosed CKD. Note: The UAE has a large and diverse Expatriate population with a different CKD profile; only the Emirati population has been provided here. Individual values have been rounded to two decimal places. Slight discrepancies may occur between the total sum reported as a result. CKD = chronic kidney disease. ∗UAE cumulative incidence where values shown are <0.01 million: Heart failure, 7328; Myocardial infarction, 4151; Stroke, 4183.
Fig. 4
Fig. 4
Projected percentage change in prevalence of kidney replacement therapy from 2022 to 2027. Notes: The UAE has a large and diverse Expatriate population with a different CKD profile; only the Emirati population has been provided here. CKD = chronic kidney disease.
Fig. 5
Fig. 5
a: Projected all-cause mortality in the diagnosed and undiagnosed CKD population in 2022, per 100,000 of the population with CKD. b: Projected cumulative incidence of all-cause mortality in people with CKD between 2022 and 2027, by CKD stage. Notes: The UAE comprised the Emirati population and also a population of those who had migrated to the country, with only the former considered in the results shown. Individual values have been rounded to one–two decimal places. Slight discrepancies may occur between the total sum reported as a result. Cumulative all-cause mortality where values are shown are <0.01 million: ∗Denmark: CKD stage 1, 7970; CKD stage 2, 36,374; CKD stage 3a, 116,474; CKD stage 3b, 69,083; CKD stage 4, 25,190; CKD stage 5, 3820. †Romania: CKD stage 1, 18,261; CKD stage 2, 70,336; CKD stage 3a, 236,637; CKD stage 3b, 61,983; CKD stage 4, 19,474; CKD stage 5, 3041. ‡UAE: CKD stage 1, 2760; CKD stage 2, 4977; CKD stage 3a, 6660; CKD stage 3b, 2427; CKD stage 4, 1439; CKD stage 5, 505.
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References

    1. Bikbov B., Purcell C.A., Levey A.S., et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–733. - PMC - PubMed
    1. Lamb E.J., Levey A.S., Stevens P.E. The kidney disease improving global outcomes (KDIGO) guideline update for chronic kidney disease: evolution not revolution. Clin Chem. 2013;59(3):462–465. - PubMed
    1. Ortiz A., Mattace-Raso F., Soler M.J., Fouque D. Ageing meets kidney disease. Clin Kidney J. 2022;15(10):1793–1796. - PMC - PubMed
    1. Chang A., Kramer H. CKD progression: a risky business. Nephrol Dial Transplant. 2012;27(7):2607–2609. - PubMed
    1. Vivante A., Golan E., Tzur D., et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med. 2012;172(21):1644–1650. - PMC - PubMed

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