Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019

Chronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis an...

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Main Authors: Valdemir Kim, Gulnur Zhakhina, Arnur Gusmanov, Yesbolat Sakko, Mariyam Kim, Meruyert Madikenova, Zhannat Kuanshaliyeva, Alpamys Issanov, Ainur Assan, Marina Khvan, Altay Nabiyev, Sholpan Altynova, Abduzhappar Gaipov
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182
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author Valdemir Kim
Gulnur Zhakhina
Arnur Gusmanov
Yesbolat Sakko
Mariyam Kim
Meruyert Madikenova
Zhannat Kuanshaliyeva
Alpamys Issanov
Ainur Assan
Marina Khvan
Altay Nabiyev
Sholpan Altynova
Abduzhappar Gaipov
author_facet Valdemir Kim
Gulnur Zhakhina
Arnur Gusmanov
Yesbolat Sakko
Mariyam Kim
Meruyert Madikenova
Zhannat Kuanshaliyeva
Alpamys Issanov
Ainur Assan
Marina Khvan
Altay Nabiyev
Sholpan Altynova
Abduzhappar Gaipov
author_sort Valdemir Kim
collection DOAJ
description Chronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis and survival post-RRT initiation in Kazakhstan remain limited. This study aims to investigate the impact of late CKD diagnosis on survival prognosis after RRT initiation. Data were acquired from the Unified National Electronic Health System (UNEHS) for CKD patients initiating RRT between 2014 and 2019. Survival post-RRT initiation was assessed using the Cox Proportional Hazards Model. Totally, 211,655 CKD patients were registered in the UNEHS databases and 9,097 (4.3%) needed RRT. The most prevalent age group among RRT patients is 45–64 years, with a higher proportion of males (56%) and Kazakh ethnicity (64%). Seventy-four percent of patients were diagnosed late. The median follow-up time was 537 (IQR: 166–1101) days. Late diagnosis correlated with worse survival (HR = 1.18, p < 0.001). Common comorbidities among RRT patients include hypertension (47%), diabetes (21%), and cardiovascular diseases (26%). The history of transplantation significantly influenced survival. Regional disparities in survival probabilities were observed, highlighting the need for collaborative efforts in healthcare delivery. This study underscores the substantial burden of CKD in Kazakhstan, with a majority of patients diagnosed late. Early detection strategies and timely kidney transplantation emerge as crucial interventions to enhance survival outcomes.
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spelling doaj-art-55c744ce77ff484c9513d4d84ba959d22025-08-20T02:38:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2398182Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019Valdemir Kim0Gulnur Zhakhina1Arnur Gusmanov2Yesbolat Sakko3Mariyam Kim4Meruyert Madikenova5Zhannat Kuanshaliyeva6Alpamys Issanov7Ainur Assan8Marina Khvan9Altay Nabiyev10Sholpan Altynova11Abduzhappar Gaipov12Department of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanClinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, KazakhstanSchool of Population and Public Health, University of British Columbia, Vancouver, CanadaDepartment of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanClinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, KazakhstanDepartment of Medical and Regulatory Affairs, CF “University Medical Center”, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanChronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis and survival post-RRT initiation in Kazakhstan remain limited. This study aims to investigate the impact of late CKD diagnosis on survival prognosis after RRT initiation. Data were acquired from the Unified National Electronic Health System (UNEHS) for CKD patients initiating RRT between 2014 and 2019. Survival post-RRT initiation was assessed using the Cox Proportional Hazards Model. Totally, 211,655 CKD patients were registered in the UNEHS databases and 9,097 (4.3%) needed RRT. The most prevalent age group among RRT patients is 45–64 years, with a higher proportion of males (56%) and Kazakh ethnicity (64%). Seventy-four percent of patients were diagnosed late. The median follow-up time was 537 (IQR: 166–1101) days. Late diagnosis correlated with worse survival (HR = 1.18, p < 0.001). Common comorbidities among RRT patients include hypertension (47%), diabetes (21%), and cardiovascular diseases (26%). The history of transplantation significantly influenced survival. Regional disparities in survival probabilities were observed, highlighting the need for collaborative efforts in healthcare delivery. This study underscores the substantial burden of CKD in Kazakhstan, with a majority of patients diagnosed late. Early detection strategies and timely kidney transplantation emerge as crucial interventions to enhance survival outcomes.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182Chronic kidney diseaserenal replacement therapylate diagnosissurvival prognosisend-stage renal disease
spellingShingle Valdemir Kim
Gulnur Zhakhina
Arnur Gusmanov
Yesbolat Sakko
Mariyam Kim
Meruyert Madikenova
Zhannat Kuanshaliyeva
Alpamys Issanov
Ainur Assan
Marina Khvan
Altay Nabiyev
Sholpan Altynova
Abduzhappar Gaipov
Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
Renal Failure
Chronic kidney disease
renal replacement therapy
late diagnosis
survival prognosis
end-stage renal disease
title Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
title_full Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
title_fullStr Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
title_full_unstemmed Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
title_short Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
title_sort late diagnosis of ckd and associated survival after initiation of renal replacement therapy in kazakhstan analysis of nationwide electronic healthcare registry 2014 2019
topic Chronic kidney disease
renal replacement therapy
late diagnosis
survival prognosis
end-stage renal disease
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182
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