#3667 REVEAL-CKD: PREVALENCE OF UNDIAGNOSED STAGE 3 CHRONIC KIDNEY DISEASE IN AUSTRALIA, BRAZIL, CANADA AND SPAIN

Abstract

Abstract Background and Aims Chronic kidney disease (CKD) is a progressive condition that affects >850 million people globally. Global clinical guidelines from K-DIGO recommend early CKD identification and management to mitigate disease progression. The REVEAL-CKD study aims to assess the prevalence of, and factors associated with, undiagnosed stage 3 CKD across 11 countries. Here we report data from 4 countries in 4 continents. Method REVEAL-CKD is a multi-national, observational study, using secondary data from electronic medical records (EMR) and claims data. For this analysis, data were extracted from Australian General Practices through Pen CS (Australia), University of Sao Paulo (Brazil), the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) (Canada), and BIGPAC (Spain). The study cohort included patients aged ≥18 years with two consecutive estimated glomerular filtration rate (eGFR) values ≥30 and <60 mL/min/1.73 m2 recorded 91-730 days apart. The date of the second qualifying eGFR was the index date. Patients with no CKD diagnosis code before and up to 6 months after their index date were considered undiagnosed. The prevalence of undiagnosed CKD was calculated as the ratio of undiagnosed patients to all patients meeting the study inclusion criteria. Results The prevalence and baseline characteristics of undiagnosed Stage 3 CKD appear in Table 1. In all 4 countries, the undiagnosed prevalence was >80% and predominantly was more commonly observed in female patients, in patients aged > 65y, and remained high in patients with baseline comorbidities, particularly for those at highest risk of CKD (DM, CVD, HTN). Underreporting of CKD diagnosis in Brazil may be due to the inability to code for >1 condition in a patient. Conclusion These results indicate that a large proportion of patients across four world regions and who have biochemical evidence of early CKD lack a recorded diagnosis. An opportunity exists to identify, diagnose, and implement guideline-directed management for early CKD in order to delay its complications and improve clinical outcomes.