Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories
Introduction: Urinary albumin-to-creatinine ratio (uACR) is an independent predictor of chronic kidney disease (CKD) progression. However there is limited evidence on the burden of CKD according to uACR categories at the population level. This study estimates future clinical and financial burden of...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924019491 |
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| author | Luca De Nicola Ricardo Correa-Rotter Juan F. Navarro-González Albert Power Michal Nowicki Istvan Wittmann Jean-Michel Halimi Juan Jose Garcia Sanchez Claudia Cabrera Salvatore Barone Timothy Coker Lise Retat |
| author_facet | Luca De Nicola Ricardo Correa-Rotter Juan F. Navarro-González Albert Power Michal Nowicki Istvan Wittmann Jean-Michel Halimi Juan Jose Garcia Sanchez Claudia Cabrera Salvatore Barone Timothy Coker Lise Retat |
| author_sort | Luca De Nicola |
| collection | DOAJ |
| description | Introduction: Urinary albumin-to-creatinine ratio (uACR) is an independent predictor of chronic kidney disease (CKD) progression. However there is limited evidence on the burden of CKD according to uACR categories at the population level. This study estimates future clinical and financial burden of CKD according to uACR categories using the Inside CKD microsimulation. Methods: The Inside CKD model is an individual patient level microsimulation that emulates national populations based on demographic, epidemiological, and economic data. The analysis estimates clinical and economic outcomes over time according to the Kidney Disease: Improving Global Outcomes (KDIGO) uACR categories (A1–A3) at a population level for 31 countries and regions. Results: CKD populations (diagnosed and undiagnosed individuals, stages G3–G5) were projected to be predominantly within uACR categories A1 and A2 in 2022. Projected cumulative incidence of CKD stage transitions (disease progression) and cardio-renal complications (heart failure, myocardial infarction, stroke, and all-cause mortality) occurred mostly in uACR categories A1 and A2 between 2022 and 2027. Patients in uACR categories A1 and A2, who represent the largest proportion of patients with CKD, were projected to incur most of the health care costs associated with CKD management and cardio-renal complications for the diagnosed population (prevalence 2027). Conclusion: This study highlights the disproportionate population-level clinical and economic burden associated with individuals within KDIGO uACR categories A1 and A2, who represent most of the CKD population. This awareness will help health care decision makers to appropriately allocate resources and interventions to the CKD population, including those with mild to moderately increased albuminuria, to reduce clinical and economic burden associated with CKD. |
| format | Article |
| id | doaj-art-790d5ee2175c4aed8aec01882df54e92 |
| institution | OA Journals |
| issn | 2468-0249 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj-art-790d5ee2175c4aed8aec01882df54e922025-08-20T02:05:52ZengElsevierKidney International Reports2468-02492024-12-019123464347610.1016/j.ekir.2024.09.021Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio CategoriesLuca De Nicola0Ricardo Correa-Rotter1Juan F. Navarro-González2Albert Power3Michal Nowicki4Istvan Wittmann5Jean-Michel Halimi6Juan Jose Garcia Sanchez7Claudia Cabrera8Salvatore Barone9Timothy Coker10Lise Retat11University Luigi, Vanvitelli, Naples, ItalyInstituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, MexicoHospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain; RICORS2040, Instituto de Salud Carlos III, Madrid, Spain; ITB, Universidad de La Laguna, Santa Cruz de Tenerife, Spain; Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, SpainNorth Bristol NHS Trust, Bristol, UKMedical University of Lodz, PolandDepartment of Medicine and Nephrology-Diabetes Center, University of Pécs Medical School, HungaryService de Néphrologie-HTA, Dialyses, Transplantation Rénale, CHU Tours, University of Tours, Tours, France; INSERM UMR1327, University of Tours, Tours, FranceHealth Economic and Payer Evidence, Biopharmaceuticals, AstraZeneca, Cambridge, UK; Correspondence: Juan Jose Garcia Sanchez, AstraZeneca PLC Health Economic and Payer Evidence Academy House 136 Hills Road Cambridge, Cambridgeshire CB2 8PA, United Kingdom.Real World Science and Analytics, AstraZeneca, Gothenburg, SwedenGlobal Medical Affairs, BioPharmaceuticals, AstraZeneca, Gaithersburg, Maryland, USAHealthLumen Limited, London, UKHealthLumen Limited, London, UKIntroduction: Urinary albumin-to-creatinine ratio (uACR) is an independent predictor of chronic kidney disease (CKD) progression. However there is limited evidence on the burden of CKD according to uACR categories at the population level. This study estimates future clinical and financial burden of CKD according to uACR categories using the Inside CKD microsimulation. Methods: The Inside CKD model is an individual patient level microsimulation that emulates national populations based on demographic, epidemiological, and economic data. The analysis estimates clinical and economic outcomes over time according to the Kidney Disease: Improving Global Outcomes (KDIGO) uACR categories (A1–A3) at a population level for 31 countries and regions. Results: CKD populations (diagnosed and undiagnosed individuals, stages G3–G5) were projected to be predominantly within uACR categories A1 and A2 in 2022. Projected cumulative incidence of CKD stage transitions (disease progression) and cardio-renal complications (heart failure, myocardial infarction, stroke, and all-cause mortality) occurred mostly in uACR categories A1 and A2 between 2022 and 2027. Patients in uACR categories A1 and A2, who represent the largest proportion of patients with CKD, were projected to incur most of the health care costs associated with CKD management and cardio-renal complications for the diagnosed population (prevalence 2027). Conclusion: This study highlights the disproportionate population-level clinical and economic burden associated with individuals within KDIGO uACR categories A1 and A2, who represent most of the CKD population. This awareness will help health care decision makers to appropriately allocate resources and interventions to the CKD population, including those with mild to moderately increased albuminuria, to reduce clinical and economic burden associated with CKD.http://www.sciencedirect.com/science/article/pii/S2468024924019491burden of diseasecardio-renal complicationchronic kidney diseaseeconomic burdenend-stage kidney diseaseurine albumin-to-creatinine ratio |
| spellingShingle | Luca De Nicola Ricardo Correa-Rotter Juan F. Navarro-González Albert Power Michal Nowicki Istvan Wittmann Jean-Michel Halimi Juan Jose Garcia Sanchez Claudia Cabrera Salvatore Barone Timothy Coker Lise Retat Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories Kidney International Reports burden of disease cardio-renal complication chronic kidney disease economic burden end-stage kidney disease urine albumin-to-creatinine ratio |
| title | Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories |
| title_full | Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories |
| title_fullStr | Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories |
| title_full_unstemmed | Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories |
| title_short | Projecting the Population Level Burden of CKD Progression According to Urine Albumin-to-Creatinine Ratio Categories |
| title_sort | projecting the population level burden of ckd progression according to urine albumin to creatinine ratio categories |
| topic | burden of disease cardio-renal complication chronic kidney disease economic burden end-stage kidney disease urine albumin-to-creatinine ratio |
| url | http://www.sciencedirect.com/science/article/pii/S2468024924019491 |
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