Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study
Abstract Objectives To describe the clinical characteristics, comorbidity, and medical treatment in a primary care population with chronic kidney disease (CKD). Additionally, to investigate how primary care physicians (PCPs) diagnose, manage and treat impaired kidney function, including uptake of ca...
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2025-02-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-025-02721-4 |
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| author | Morten Lindhardt Søren Tang Knudsen Thomas Saxild Morten Charles Rikke Borg |
| author_facet | Morten Lindhardt Søren Tang Knudsen Thomas Saxild Morten Charles Rikke Borg |
| author_sort | Morten Lindhardt |
| collection | DOAJ |
| description | Abstract Objectives To describe the clinical characteristics, comorbidity, and medical treatment in a primary care population with chronic kidney disease (CKD). Additionally, to investigate how primary care physicians (PCPs) diagnose, manage and treat impaired kidney function, including uptake of cardio-renoprotective renin–angiotensin–aldosterone system inhibitors (RAASis) and sodium glucose co-transporter 2 inhibitors (SGLT2is). Design An observational study of CKD prevalence, treatment patterns and comorbidities in primary care based on patient record data combined with a questionnaire on diagnosis, management and treatment of impaired kidney function in a real-world, primary care setting. Setting In all 128 primary care clinics in Denmark of 211 randomly invited and a quetionnaire completed by 125/128 participating PCPs. Methods A computerized selection identified 12 random individuals with CKD per clinic with ≥ 2 measurements of eGFR < 60 mL/min/1.73 m2 or UACR > 30 mg/g within two years (N = 1 497). Pre-specified data collected from individual electronic health records included demographics, clinical variables, comorbidities, and relevant prescribed medications. Results Of the CKD study population (N = 1 497), 80% had hypertension, 32% diabetes (DM), 13% heart failure (HF), 59% no DM/HF. ACEis/ARBs were prescribed to 65%, statins to 56%, SGTL2is to 14%, and MRAs to 8% of all individuals. Treatment patterns differed between individuals with varying comorbidities, e.g., ACEis/ARBs usage was higher in DM (76%) or HF (74%) vs. no DM/HF (58%), as was statin usage (76% in DM vs. 45% in no DM/HF). SGTL2i usage in no DM/HF was low. Most PCPs identified CKD using eGFR < 60 mL/min/1.73 m2 (62%) or UACR > 30 mg/g (58%) and 62% reported initiating treatment to retard kidney function decline. Conclusions Despite good PCP awareness and wish to use relevant guidelines, a gap exists in implementation of cardio-renoprotective treatment, especially in individuals without DM/HF. This offers an opportunity for clear recommendations to PCPs to optimize early cardio-renal protection in individuals with CKD. |
| format | Article |
| id | doaj-art-87c9045f824a4324a48ee7bd18120f48 |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-87c9045f824a4324a48ee7bd18120f482025-02-02T12:35:32ZengBMCBMC Primary Care2731-45532025-02-0126111210.1186/s12875-025-02721-4Treating chronic kidney disease in Danish primary care: results from the observational ATLAS studyMorten Lindhardt0Søren Tang Knudsen1Thomas Saxild2Morten CharlesRikke Borg3Department of Internal Medicine, Holbaek HospitalDepartment of Internal Medicine, Holbaek HospitalSteno Diabetes Center Aarhus, Aarhus University HospitalDepartment of Clinical Medicine, University of CopenhagenAbstract Objectives To describe the clinical characteristics, comorbidity, and medical treatment in a primary care population with chronic kidney disease (CKD). Additionally, to investigate how primary care physicians (PCPs) diagnose, manage and treat impaired kidney function, including uptake of cardio-renoprotective renin–angiotensin–aldosterone system inhibitors (RAASis) and sodium glucose co-transporter 2 inhibitors (SGLT2is). Design An observational study of CKD prevalence, treatment patterns and comorbidities in primary care based on patient record data combined with a questionnaire on diagnosis, management and treatment of impaired kidney function in a real-world, primary care setting. Setting In all 128 primary care clinics in Denmark of 211 randomly invited and a quetionnaire completed by 125/128 participating PCPs. Methods A computerized selection identified 12 random individuals with CKD per clinic with ≥ 2 measurements of eGFR < 60 mL/min/1.73 m2 or UACR > 30 mg/g within two years (N = 1 497). Pre-specified data collected from individual electronic health records included demographics, clinical variables, comorbidities, and relevant prescribed medications. Results Of the CKD study population (N = 1 497), 80% had hypertension, 32% diabetes (DM), 13% heart failure (HF), 59% no DM/HF. ACEis/ARBs were prescribed to 65%, statins to 56%, SGTL2is to 14%, and MRAs to 8% of all individuals. Treatment patterns differed between individuals with varying comorbidities, e.g., ACEis/ARBs usage was higher in DM (76%) or HF (74%) vs. no DM/HF (58%), as was statin usage (76% in DM vs. 45% in no DM/HF). SGTL2i usage in no DM/HF was low. Most PCPs identified CKD using eGFR < 60 mL/min/1.73 m2 (62%) or UACR > 30 mg/g (58%) and 62% reported initiating treatment to retard kidney function decline. Conclusions Despite good PCP awareness and wish to use relevant guidelines, a gap exists in implementation of cardio-renoprotective treatment, especially in individuals without DM/HF. This offers an opportunity for clear recommendations to PCPs to optimize early cardio-renal protection in individuals with CKD.https://doi.org/10.1186/s12875-025-02721-4Chronic kidney diseasePrimary careTreatmentCardio-renal protectionNephrologyObservational study |
| spellingShingle | Morten Lindhardt Søren Tang Knudsen Thomas Saxild Morten Charles Rikke Borg Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study BMC Primary Care Chronic kidney disease Primary care Treatment Cardio-renal protection Nephrology Observational study |
| title | Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study |
| title_full | Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study |
| title_fullStr | Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study |
| title_full_unstemmed | Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study |
| title_short | Treating chronic kidney disease in Danish primary care: results from the observational ATLAS study |
| title_sort | treating chronic kidney disease in danish primary care results from the observational atlas study |
| topic | Chronic kidney disease Primary care Treatment Cardio-renal protection Nephrology Observational study |
| url | https://doi.org/10.1186/s12875-025-02721-4 |
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