POS-323 INSIDE CKD: PROJECTING THE FUTURE BURDEN OF CHRONIC KIDNEY DISEASE IN EUROPE USING MICROSIMULATION MODELLING

Abstract

Chronic kidney disease (CKD) is a debilitating and costly condition, affecting about 10% of people globally. Progression of CKD is associated with increased incidence of cardiovascular events, adverse renal outcomes and mortality, as well as high costs from renal replacement therapy (RRT) in end-stage renal disease. The future trajectories of CKD prevalence, progression and outcomes and their related costs, are critical considerations for public health and policy planning. Inside CKD aims to project, for the 2020–2025 period, the public health burden of CKD in Europe using a patient-level microsimulation-based model. An initial analysis for the UK was then adapted to other European countries. A virtual population was constructed using the following data from publicly available sources: country demographics and prevalence rates of CKD, RRTs and comorbidities, along with incidence rates of related complications. In the microsimulation, CKD stages were defined according to Kidney Disease: Improving Global Outcomes (KDIGO) 2012 recommendations. Patients were categorized according to estimated glomerular filtration rate (eGFR) and albuminuria status using data from the Health Survey for England (HSE) extrapolated to the UK population. Model validation and calibration were conducted following established methods for health economic modelling. RRT projections were calibrated against historical trends from the UK Renal Registry. Preliminary results for the UK demonstrate that, irrespective of population growth, the prevalence of CKD is projected to increase by 1% (from 13% to 14%) by 2025. The size of the CKD population is projected to grow from 9.07M in 2020 to 9.63M by 2025. Changes to the profile of CKD are also projected, with an increase in the more advanced stages (3b–5) of ~7% relative to the total CKD population by 2025. Increases in CKD prevalence are projected for all age categories (18–34, 35–64 and 65+ years); however, the 35–64-year-old age category is projected to have the largest relative impact, with a 20% rise in overall cases. RRT is projected to increase by 10.9% in the general UK population. Inside CKD is a validated microsimulation model that predicts increases in CKD prevalence and associated adverse cardiorenal complications over a 5-year period. The predicted increases pose a public health concern in the UK and potentially across Europe. The largest increase in CKD is predicted to be within the 35–64-year-old ‘working’ population. This could have wider societal implications due to possible productivity losses. Policy interventions aimed at early identification of patients and slowing of disease progression could lower this projected burden. Estimates from the whole of Europe will provide information at country level.