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Differences in chronic kidney disease management based on identification and diagnosis in a population-based
Michael Olszewski1,2, Karl Bjurström3, Markus Lingman3,4,5
1Department of Research and Development, Region Halland, Halmstad, Sweden.
Journal of Nephrology
|September 27, 2025
Summary
Most chronic kidney disease (CKD) patients remain undiagnosed, leading to suboptimal care. Diagnosed CKD patients receive better management, highlighting the need for improved CKD identification strategies.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic kidney disease (CKD) affects a significant portion of the adult population, often progressing undetected.
- Late diagnosis of CKD leads to delayed interventions and poorer health outcomes.
Purpose of the Study:
- To compare the prevalence, clinical management, healthcare utilization, and mortality rates among diagnosed, proxy-diagnosed, and undiagnosed CKD patients.
- To identify disparities in care and outcomes based on CKD diagnostic status.
Main Methods:
- Retrospective observational study utilizing healthcare data from Region Halland for adults meeting KDIGO CKD criteria in 2019.
- Patients were categorized into diagnosed, proxy-diagnosed (CKD-related diagnoses), and undiagnosed (meeting criteria without ICD diagnosis) groups.
Main Results:
- 61% of 20,488 CKD patients were undiagnosed, 21% diagnosed, and 18% proxy-diagnosed.
- Diagnosed CKD patients showed higher rates of blood pressure follow-up (88%), eGFR testing (73%), UACR testing (50%), and RAS inhibitor prescription (51%) compared to other groups.
- Higher adjusted hospitalization risk (2.71) and all-cause mortality hazard ratio (2.22) were observed in diagnosed CKD patients versus undiagnosed.
Conclusions:
- CKD diagnosis is associated with more complex comorbidities, advanced disease, and frequent hospitalizations, leading to better follow-up care.
- Proxy-diagnosed CKD is prevalent and linked to suboptimal management, underscoring the need for accurate CKD identification.
- Consistent and precise CKD identification is crucial for enhancing patient outcomes and optimizing healthcare delivery.
Keywords:
Chronic kidney diseaseDisease managementEpidemiologyInternational classification of diseasesMore Related Videos
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