Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context
Summary: Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking. Methods: REVEAL-CKD is a m...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | The Lancet Regional Health. Western Pacific |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606524002694 |
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| author | Sheng Nie Shiyu Zhou Claudia Cabrera Shan Chen Mengyun Jia Shiyu Zhang Licong Su Qi Gao Navdeep Tangri Fan Fan Hou |
| author_facet | Sheng Nie Shiyu Zhou Claudia Cabrera Shan Chen Mengyun Jia Shiyu Zhang Licong Su Qi Gao Navdeep Tangri Fan Fan Hou |
| author_sort | Sheng Nie |
| collection | DOAJ |
| description | Summary: Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking. Methods: REVEAL-CKD is a multinational, observational study using real-world data in selected countries to describe factors associated with undiagnosed stage 3 CKD, time to diagnosis, and CKD management post diagnosis. We analysed patient data from 20 hospitals in the China Renal Data System. Adult patients with two consecutive estimated glomerular filtration rate (eGFR) measurements indicating stage 3 CKD (30–<60 ml/min/1.73 m2) recorded >90–730 days apart from 2015 to 2020 were eligible. Findings: Among 35,222 eligible patients, 25,214 (71.6%) were undiagnosed (lacked a CKD diagnostic code before and up to six months post-second-qualifying-eGFR). Only 2344 (9.3%) undiagnosed patients eventually received a delayed diagnosis, whose median time to diagnosis was 18.1 (95% CI: 17.6–18.8) months. Age ≥65 years, being female, stage 3A CKD, and the absence of nephrology visit and comorbidities (diabetes, established cardiovascular disease, heart failure, hypertension, or chronic nephritic syndrome) were associated with undiagnosed CKD (P < 0.001). Among the diagnosed patients, the proportion receiving ≥1 prescription of guideline-recommended medications (e.g. renin-angiotensin system inhibitors) increased and their eGFR decline attenuated post-diagnosis. Interpretation: The high proportion of undiagnosed, early-stage CKD, and delayed diagnosis are concerning. The improved prescription patterns and the attenuation of eGFR decline post-diagnosis demonstrate the importance of early diagnosis and timely intervention in CKD patients. Funding: AstraZeneca China. |
| format | Article |
| id | doaj-art-7b33166581e04702a68fd405071a1fd3 |
| institution | Kabale University |
| issn | 2666-6065 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj-art-7b33166581e04702a68fd405071a1fd32025-01-05T04:28:42ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-01-0154101275Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in contextSheng Nie0Shiyu Zhou1Claudia Cabrera2Shan Chen3Mengyun Jia4Shiyu Zhang5Licong Su6Qi Gao7Navdeep Tangri8Fan Fan Hou9Division of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDivision of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaReal World Science and Analytics, Evidence, BioPharmaceutical Medical, AstraZeneca, Mölndal, SwedenDivision of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaMedical Affairs CVRM, AstraZeneca Pharmaceutical (Hangzhou) Co. Ltd. Company, Hangzhou, ChinaBiometrics and RWE, Evidence Generation, AstraZeneca Investment (CN) Co Ltd, Shanghai, ChinaDivision of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDivision of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDivision of Nephrology, National Clinical Research Centre for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Corresponding author. Division of Nephrology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Ave, Guangzhou, 510515, China.Summary: Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking. Methods: REVEAL-CKD is a multinational, observational study using real-world data in selected countries to describe factors associated with undiagnosed stage 3 CKD, time to diagnosis, and CKD management post diagnosis. We analysed patient data from 20 hospitals in the China Renal Data System. Adult patients with two consecutive estimated glomerular filtration rate (eGFR) measurements indicating stage 3 CKD (30–<60 ml/min/1.73 m2) recorded >90–730 days apart from 2015 to 2020 were eligible. Findings: Among 35,222 eligible patients, 25,214 (71.6%) were undiagnosed (lacked a CKD diagnostic code before and up to six months post-second-qualifying-eGFR). Only 2344 (9.3%) undiagnosed patients eventually received a delayed diagnosis, whose median time to diagnosis was 18.1 (95% CI: 17.6–18.8) months. Age ≥65 years, being female, stage 3A CKD, and the absence of nephrology visit and comorbidities (diabetes, established cardiovascular disease, heart failure, hypertension, or chronic nephritic syndrome) were associated with undiagnosed CKD (P < 0.001). Among the diagnosed patients, the proportion receiving ≥1 prescription of guideline-recommended medications (e.g. renin-angiotensin system inhibitors) increased and their eGFR decline attenuated post-diagnosis. Interpretation: The high proportion of undiagnosed, early-stage CKD, and delayed diagnosis are concerning. The improved prescription patterns and the attenuation of eGFR decline post-diagnosis demonstrate the importance of early diagnosis and timely intervention in CKD patients. Funding: AstraZeneca China.http://www.sciencedirect.com/science/article/pii/S2666606524002694Chronic kidney diseaseEarly stageDiagnosisManagementChina |
| spellingShingle | Sheng Nie Shiyu Zhou Claudia Cabrera Shan Chen Mengyun Jia Shiyu Zhang Licong Su Qi Gao Navdeep Tangri Fan Fan Hou Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context The Lancet Regional Health. Western Pacific Chronic kidney disease Early stage Diagnosis Management China |
| title | Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context |
| title_full | Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context |
| title_fullStr | Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context |
| title_full_unstemmed | Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context |
| title_short | Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in ChinaResearch in context |
| title_sort | characteristics of patients with undiagnosed stage 3 chronic kidney disease results from an observational study reveal ckd in chinaresearch in context |
| topic | Chronic kidney disease Early stage Diagnosis Management China |
| url | http://www.sciencedirect.com/science/article/pii/S2666606524002694 |
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