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Baseline Characteristics of the DISCOVER CKD Prospective Cohort
Carol Pollock1, Juan-Jesus Carrero2, Eiichiro Kanda3
1Kolling Institute, Royal North Shore Hospital, University of Sydney, 10 Westbourne St, St Leonards, Sydney, NSW, 2064, Australia. carol.pollock@sydney.edu.au.
Insights
Real-world data reveal chronic kidney disease (CKD) patients face significant symptom burden, impacting quality of life. Gaps in treatment persist despite contemporary care, highlighting unmet needs in CKD management.
Area of Science:
- Nephrology
- Epidemiology
- Real-world evidence
Background:
- Limited real-world data exist for chronic kidney disease (CKD) patients, especially concerning clinical management, treatment patterns, and health-related quality of life (HRQoL).
- Understanding these aspects is crucial in the context of evolving therapies and updated standard of care guidelines.
Purpose of the Study:
- To describe the demographics, baseline characteristics, and patient-reported outcomes of adults enrolled in the prospective phase of the DISCOVER CKD study.
- To assess the real-world clinical management, treatment patterns, and HRQoL in a diverse CKD patient population.
Main Methods:
- Observational cohort study (DISCOVER CKD) enrolling adult patients with CKD.
- CKD defined by ICD-10 code or two estimated glomerular filtration rate (eGFR) measures <75 ml/min/1.73 m² recorded 91-730 days apart.
- Data collected on demographics, baseline characteristics, and patient-reported outcomes.
Main Results:
- 1052 patients enrolled from 6 countries; 69.1% had stage 2-3b CKD, 30.9% had stage 4-5 CKD.
- High prevalence of comorbidities: hypertension (72.4%), diabetes (43.0%), hyperlipidaemia (37.5%).
- Patients with stage 4-5 CKD reported greater symptom burden, worse HRQoL (SF-36), and greater work impairment (WPAI-CKD) compared to those with stage 2-3b CKD. Higher rates of anemia, hyperkalemia, and edema were observed in advanced CKD stages.
Conclusions:
- Contemporary real-world data highlight substantial symptom, medication, and psychosocial burden in CKD patients across multiple countries.
- Significant gaps in CKD treatment and management persist, indicating unmet patient needs.
- The study provides valuable insights into the real-world experience of CKD patients, informing future research and clinical practice.
Introduction:
Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.
Methods:
DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m2 recorded 91-730 days apart. We describe the demographics, baseline characteristics and patient-reported outcomes of patients enrolled in the prospective phase.
Results:
Of 1052 patients (mean age 62.5 years; 36.9% female) enrolled from the USA, UK, Spain, Italy, Sweden and Japan, 727 (69.1%) had stage 2-3b CKD and 325 (30.9%) had stage 4-5 CKD. Overall, 72.4%, 43.0% and 37.5% of patients had histories of hypertension, diabetes and hyperlipidaemia, respectively. In total, 58.7% and 14.0% were receiving renin-angiotensin-aldosterone system inhibitors (RAASi) and sodium-glucose co-transporter 2 inhibitors (SGLT2i), respectively. Compared with patients with stage 2-3b CKD, patients with stage 4-5 CKD reported numerically greater symptom burden across all 11 symptoms measured, numerically worse HRQoL across all eight categories measured using the 36-item Short Form (SF-36) questionnaire, and numerically greater impairment at work across all four categories measured using the Work Productivity and Activity Impairment chronic kidney disease (WPAI-CKD) questionnaire. Compared with patients with stage 2-3b CKD, a higher proportion of patients with stage 4-5 CKD had anaemia, hyperkalaemia and oedema (49.8% vs. 16.9%, 21.8% vs. 8.4% and 17.5% vs. 9.5%, respectively).
Conclusions:
These contemporary real-world data from six countries highlight the substantial symptom, medication and psychosocial burden associated with CKD, and continued gaps in treatment. Graphical abstract available for this article.
Trial Registration:
ClinicalTrials.gov identifier, NCT04034992.
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