Earlier screening key to improving outcomes on CKD say REVEAL-CKD authors

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Image credit: Raquibul Hannan

AstraZeneca has presented new data at the American Society of Nephrology (ASN) Kidney Week 2022 (3–6 November, Orlando, USA) on the importance of earlier screening and diagnosis of chronic kidney disease (CKD). These findings were also simultaneously published in the Journal of the American Society of Nephrology.

Data from the REVEAL-CKD multinational study found high rates of underdiagnosis, 61.6% to 95.5%, in the countries studied (USA, Italy, Germany, Japan and France). Country-specific electronic medical records and insurance claims were analysed for patients with estimated glomerular filtration rate (eGFR) between ≥30 and <60 mL/min/1.73 m2, equal to CKD Stage 3, who lacked a diagnosis of CKD. This analysis further demonstrated that once a diagnosis was made, patients did receive timely CKD monitoring and management of their disease, leading to real-life patient benefits. 

The importance of receiving a CKD diagnosis can be seen in its impact on annual kidney function decline, i.e., the eGFR slope, states the AstraZeneca press release. The REVEAL-CKD trial evaluated eGFR decline before and after CKD diagnosis, which was recorded for 27,000 patients in the US TriNetX database. These patients had a median eGFR decline in the two-year period prior to CKD diagnosis of -4.12 (95% confidence interval [CI]: -4.23, -4.02) and in the two-year period after diagnosis of only -0.30 (95% CI: -0.44, -0.14).   

Navdeep Tangri (University of Manitoba, Winnipeg, Canada) said: “The level of underdiagnosis of chronic kidney disease, even in countries with well-established and -financed healthcare systems, is alarming. These data from REVEAL-CKD reinforce the need to proactively screen and diagnose early-stage kidney disease so that patients can receive guideline-directed monitoring and treatment. This can prevent or delay progression to kidney failure and other serious comorbidities.” 

In addition to presenting data at ASN Kidney Week 2022 on the urgent need for earlier diagnosis and screening, AstraZeneca supported the International Society of Nephrology in creating a quick one-minute quiz to offer insight into whether a patient may be at risk for CKD and to provide them with more information on the risk factors to be aware of to help start the conversation with their doctor. 

AstraZeneca also noted the impact of Farxiga via the INSIDE-CKD study, which drew on 100,000 patients in 23 countries to conclude that the drug could cut healthcare costs by 33% by delaying disease progression and reducing incidence of cardiorenal events. 

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