Inside CKD: Cost-Effectiveness of Multinational Screening for CKD.

Area of Science:

• Nephrology
• Public Health
• Health Economics

Background:

• Early detection of chronic kidney disease (CKD) is crucial for slowing progression, yet many patients remain undiagnosed in early stages.
• Current CKD screening practices vary, potentially leading to missed diagnoses and delayed treatment initiation.

Purpose of the Study:

• To evaluate the cost-effectiveness of different multinational CKD screening strategies.
• To compare screening approaches in general and high-risk populations from a payer's perspective.

Main Methods:

• Utilized the Inside CKD microsimulation model to project virtual populations across 31 countries.
• Assessed screening strategies including "2 eGFR only" and "2 eGFR and 1 UACR" versus current practice.
• Included general populations (≥45 and ≥65 years) and high-risk subgroups (type 2 diabetes, hypertension, cardiovascular disease).

Main Results:

• CKD screening using "2 eGFR and 1 UACR" was cost-effective in the general population (≥45 years) across all studied countries.
• "2 eGFR only" strategy was cost-effective in all but one country.
• The "2 eGFR and 1 UACR" strategy demonstrated superior cost-effectiveness and significantly increased CKD diagnosis rates.

Conclusions:

• CKD screening, particularly in individuals aged 45 and older, is a cost-effective public health strategy worldwide.
• The findings support global guidelines recommending simultaneous estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) testing, considering local factors.