Characteristics of patients with undiagnosed stage 3 chronic kidney disease: results from an observational study (REVEAL-CKD) in China

作者：Sheng Nie, Shi-Yu Zhou, Claudia Cabrera, Shan Chen, Mengyun Jia, Shiyu Zhang, Licong Su, Qi Gao, Navdeep Tangri, Fan Fan Hou · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2024.101275 · 被引用次数：11 · 研究领域：Chronic Kidney Disease and Diabetes、Dialysis and Renal Disease Management、Chronic Disease Management Strategies

Background: Early diagnosis of chronic kidney disease (CKD) is crucial for timely intervention to delay disease progression and improve patient outcomes. However, data for clinical characteristics of Chinese patients with undiagnosed, early-stage CKD are lacking. Methods: ) recorded >90-730 days apart from 2015 to 2020 were eligible. Findings: Among 35,222 eligible patients, 25,214 (71.6%) were undiagnosed (lacked a CKD diagnostic code before and up to six months post-second-qualifying-eGFR). Only 2344 (9.3%) undiagnosed patients eventually received a delayed diagnosis, whose median time to diagnosis was 18.1 (95% CI: 17.6-18.8) months. Age ≥65 years, being female, stage 3A CKD, and the absence of nephrology visit and comorbidities (diabetes, established cardiovascular disease, heart failure, hypertension, or chronic nephritic syndrome) were associated with undiagnosed CKD (P < 0.001). Among the diagnosed patients, the proportion receiving ≥1 prescription of guideline-recommended medications (e.g. renin-angiotensin system inhibitors) increased and their eGFR decline attenuated post-diagnosis. Interpretation: The high proportion of undiagnosed, early-stage CKD, and delayed diagnosis are concerning. The improved prescription patterns and the attenuation of eGFR decline post-diagnosis demonstrate the importance of early diagnosis and timely intervention in CKD patients. Funding: AstraZeneca China.