Impact of Improved Diagnosis and Treatment on Holistic CKD Burden
Introduction: Chronic kidney disease (CKD) is an underdiagnosed and undertreated disease despite the availability of effective interventions. The potential clinical, economic, and environmental impacts of increased diagnosis and improved adherence to guideline-directed medical therapies (GDMTs) reco...
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| Language: | English |
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Elsevier
2025-08-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024925003420 |
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| author | Navdeep Tangri Stacey Priest Anthony Zara Bo Ren Long Jieling Chen Naveen Rao Clélia-Elsa Froguel Breonny Robson Nick Guldemond Matthew Eckelman Ana Flavia Moura Ralph Audehm Fiona Adshead Ming-hui Zhao Christoph Wanner Steven Chadban |
| author_facet | Navdeep Tangri Stacey Priest Anthony Zara Bo Ren Long Jieling Chen Naveen Rao Clélia-Elsa Froguel Breonny Robson Nick Guldemond Matthew Eckelman Ana Flavia Moura Ralph Audehm Fiona Adshead Ming-hui Zhao Christoph Wanner Steven Chadban |
| author_sort | Navdeep Tangri |
| collection | DOAJ |
| description | Introduction: Chronic kidney disease (CKD) is an underdiagnosed and undertreated disease despite the availability of effective interventions. The potential clinical, economic, and environmental impacts of increased diagnosis and improved adherence to guideline-directed medical therapies (GDMTs) recommended for patients with CKD are not well-understood. Methods: Eight country populations (Australia, Brazil, China, Germany, The Netherlands, Spain, UK, and USA) were simulated for 25 years using the IMPACT CKD model to compare burdens under various diagnosis and GDMT adherence scenarios versus current practice. GDMT consisted of kidney protecting, glucose lowering, lipid lowering, as well as antihypertensive and lifestyle interventions. Patients could be treated with 1 or multiple therapies, if eligible, and no guideline changes occurred over the time horizon. Treatment effects were assumed multiplicative. Results: Scenarios with improved GDMT adherence projected cumulative decreases in dialysis, cardiovascular (CV) events, and death by −3.2% to −23.2%, −12.2% to −41.4%, and −2.3% to −9.3%, respectively, compared with current practice over 10 years. Because of delayed CKD progression, kidney replacement therapy (KRT) costs and environmental burden were also projected to decrease by −2.5% to −19.4% and −2.7% to −21.2%, respectively, compared with current practice. All treatment scenarios predicted greater improvements over 25 years, underscoring the long-term impact of CKD, and highlighting the importance of early intervention. Conclusion: Differences in projected impacts between countries are multifactorial, though they are sensitive to demographics and health care systems. Implementation of policies that lead to improved detection and treatment of CKD are urgently required across the globe to mitigate the growing burdens of CKD on patients and caregivers, health care systems, society, and our environment. |
| format | Article |
| id | doaj-art-78f920d4fbd645f9ac114cfc19d3a464 |
| institution | DOAJ |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-78f920d4fbd645f9ac114cfc19d3a4642025-08-20T02:52:56ZengElsevierKidney International Reports2468-02492025-08-011082608262010.1016/j.ekir.2025.05.039Impact of Improved Diagnosis and Treatment on Holistic CKD BurdenNavdeep Tangri0Stacey Priest1Anthony Zara2Bo Ren Long3Jieling Chen4Naveen Rao5Clélia-Elsa Froguel6Breonny Robson7Nick Guldemond8Matthew Eckelman9Ana Flavia Moura10Ralph Audehm11Fiona Adshead12Ming-hui Zhao13Christoph Wanner14Steven Chadban15University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Value & Evidence, EVERSANA, Burlington, Ontario, CanadaDepartment of Value & Evidence, EVERSANA, Burlington, Ontario, CanadaDepartment of Value & Evidence, EVERSANA, Burlington, Ontario, CanadaBioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, USA; Correspondence: Jieling Chen, BioPharmaceuticals Medical, AstraZeneca, 1 Medimmune Way, Gaithersburg, Maryland 20878, USA.BioPharmaceuticals Medical, AstraZeneca, Cambridge, UKBioPharmaceuticals Medical, AstraZeneca, Cambridge, UKKidney Health Australia, Melbourne, Victoria, AustraliaLeiden University Medical Centre, Leiden, The NetherlandsDepartment of Civil & Environmental Engineering, Northeastern University, Boston, Massachusetts, USAEscola Bahiana de Medicina e Saúde Pública, Salvador, BrazilDepartment of General Practice, University of Melbourne, Melbourne, AustraliaSustainable Healthcare Coalition, Devon, UKRenal Division, Peking University First Hospital Peking University Institute of Nephrology Beijing, People's Republic of ChinaDivision of Nephrology, University Hospital of Würzburg, Würzburg, GermanyRoyal Prince Alfred Hospital, Camperdown, AustraliaIntroduction: Chronic kidney disease (CKD) is an underdiagnosed and undertreated disease despite the availability of effective interventions. The potential clinical, economic, and environmental impacts of increased diagnosis and improved adherence to guideline-directed medical therapies (GDMTs) recommended for patients with CKD are not well-understood. Methods: Eight country populations (Australia, Brazil, China, Germany, The Netherlands, Spain, UK, and USA) were simulated for 25 years using the IMPACT CKD model to compare burdens under various diagnosis and GDMT adherence scenarios versus current practice. GDMT consisted of kidney protecting, glucose lowering, lipid lowering, as well as antihypertensive and lifestyle interventions. Patients could be treated with 1 or multiple therapies, if eligible, and no guideline changes occurred over the time horizon. Treatment effects were assumed multiplicative. Results: Scenarios with improved GDMT adherence projected cumulative decreases in dialysis, cardiovascular (CV) events, and death by −3.2% to −23.2%, −12.2% to −41.4%, and −2.3% to −9.3%, respectively, compared with current practice over 10 years. Because of delayed CKD progression, kidney replacement therapy (KRT) costs and environmental burden were also projected to decrease by −2.5% to −19.4% and −2.7% to −21.2%, respectively, compared with current practice. All treatment scenarios predicted greater improvements over 25 years, underscoring the long-term impact of CKD, and highlighting the importance of early intervention. Conclusion: Differences in projected impacts between countries are multifactorial, though they are sensitive to demographics and health care systems. Implementation of policies that lead to improved detection and treatment of CKD are urgently required across the globe to mitigate the growing burdens of CKD on patients and caregivers, health care systems, society, and our environment.http://www.sciencedirect.com/science/article/pii/S2468024925003420chronic kidney diseasedisease burdenguideline directed medical therapyhealth policy modelkidney replacement therapytargeted screening |
| spellingShingle | Navdeep Tangri Stacey Priest Anthony Zara Bo Ren Long Jieling Chen Naveen Rao Clélia-Elsa Froguel Breonny Robson Nick Guldemond Matthew Eckelman Ana Flavia Moura Ralph Audehm Fiona Adshead Ming-hui Zhao Christoph Wanner Steven Chadban Impact of Improved Diagnosis and Treatment on Holistic CKD Burden Kidney International Reports chronic kidney disease disease burden guideline directed medical therapy health policy model kidney replacement therapy targeted screening |
| title | Impact of Improved Diagnosis and Treatment on Holistic CKD Burden |
| title_full | Impact of Improved Diagnosis and Treatment on Holistic CKD Burden |
| title_fullStr | Impact of Improved Diagnosis and Treatment on Holistic CKD Burden |
| title_full_unstemmed | Impact of Improved Diagnosis and Treatment on Holistic CKD Burden |
| title_short | Impact of Improved Diagnosis and Treatment on Holistic CKD Burden |
| title_sort | impact of improved diagnosis and treatment on holistic ckd burden |
| topic | chronic kidney disease disease burden guideline directed medical therapy health policy model kidney replacement therapy targeted screening |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925003420 |
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