Diagnosis Patterns of CKD and Anemia in the Japanese Population

Area of Science:

• Nephrology
• Internal Medicine
• Public Health

Background:

• Early intervention for chronic kidney disease (CKD) and renal anemia is crucial but often hindered by asymptomatic early stages leading to underdiagnosis.
• CKD and anemia frequently coexist and require timely management to prevent disease progression and complications.

Purpose of the Study:

• To assess the proportion of patients with stages G3-G5 CKD and/or anemia who lack a formal diagnosis or treatment records in Japan.
• To identify diagnostic gaps for CKD and anemia in different patient populations using administrative claims data.

Main Methods:

• Retrospective analysis of Japanese administrative claims data from general and hospital populations (2008-2017).
• CKD staging based on estimated glomerular filtration rate (eGFR); anemia defined by hemoglobin (Hb) levels per Japanese guidelines.
• Estimation of patients with eGFR-defined CKD stages G3-G5 or Hb-defined anemia lacking corresponding diagnoses or treatments.

Main Results:

• A significant majority of patients with stage G3 CKD (e.g., 95.0% general, 89.2% hospital for G3a) lacked a CKD diagnosis, though some received antihypertensives.
• Many anemic patients with G3 CKD also lacked anemia diagnoses or treatment (e.g., 75.7% general, 56.2% hospital for G3a).
• Diagnosis rates for both CKD and anemia increased with more advanced stages (G4 and G5).

Conclusions:

• A substantial number of patients with early-stage CKD (G3) and associated anemia are undiagnosed.
• Despite diagnostic gaps, some patients received appropriate treatments, indicating potential for improved care pathways.
• Targeted outreach and screening for CKD and anemia in earlier disease stages are recommended to improve patient outcomes.