New results from one of the largest real-world evidence studies of chronic kidney disease (CKD) reveal the high burden of the disease on patients and healthcare systems, with an estimated disease prevalence of 10% of the adult population.[1] Results from the CArdioREnal and MEtabolic (CaReMe) CKD study were published today in The Lancet Regional Health - Europe (https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00132-6/fulltext).

The multinational study of 2.4 million CKD patients across 9 countries in Europe, plus Israel and Canada estimates the prevalence, outcomes and cost of CKD. While CKD is estimated to be one of the most common diseases affecting one in ten adults, it was found that two out of three patients identified to have CKD in the study were not diagnosed, putting them at high risk of morbidity and mortality and constituting a significant burden on healthcare providers and systems.[1]

Professor Navdeep Tangri, MD PhD, Department of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Canada, said: "To date, estimates of the prevalence, impact and costs of CKD varied widely due to limited studies of the disease. The CaReMe CKD study is one of the largest, longest and broadest studies assessing this chronic disease and adding to the body of evidence for CKD. The results highlight the considerable public health impact of CKD and the importance of early detection and disease management to improve patients' lives and reduce healthcare costs."

Alexander de Giorgio-Miller, Senior Vice President, Global Medical, AstraZeneca, said: "We know there remains significant unmet need in chronic kidney disease, with millions more patients yet to be diagnosed. Real world evidence studies like this are critical to build our understanding of the gaps in diagnosis and clinical care pathways, and to set ambitious quality standards to give patients better access to medicines with the potential to prevent disease progression, disability and premature death."

CKD is a growing global health burden with increasing contribution to total mortality, and substantial financial costs and impact on healthcare providers.[1-4] The study found that between 6-9% of patients with CKD die each year, and the leading cause of hospital visits and healthcare costs were CKD events and co-morbidities such as heart failure (HF).[1] The impact of CKD is expected to rise in the years ahead, with both the total number of CKD cases and costs for managing CKD projected to increase even further.[1,5]

Notes

CKD
CKD is a serious, progressive condition, affecting nearly 850 million people worldwide.[6] CKD is defined by decreased kidney function (shown by reduced estimated glomerular filtration rate (eGFR) or markers of kidney damage, or both, for at least three months).[4] The most common causes of CKD are diabetes, hypertension and glomerulonephritis.[7] CKD is associated with significant patient morbidity and an increased risk of CV events, such as heart failure (HF) and premature death.[8] In its most advanced and severe stage, known as ESKD, kidney damage and deterioration of kidney function have progressed to the point where dialysis or kidney transplantation are required.[9] The majority of patients with CKD are more likely to die from CV causes before reaching ESKD.[10]

CaReMe CKD
The CaReMe CKD study, authored by experts from more than 15 research organisations in Europe and Canada and sponsored by AstraZeneca, is one of the largest and most contemporary (years 2018-2021) CKD studies, including data from 2.4 million CKD patients across 11 countries including Belgium, Canada, Germany, Israel, The Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom. The study assessed individual-level data obtained from digital healthcare systems to determine the prevalence of each stage of CKD and to detail patient characteristics, risks, clinical outcomes and costs associated with CKD across the participating countries. Patients either had a confirmed diagnosis of CKD or measured CKD based on their urine albumin-creatinine ratio (uACR) value (i.e. level of albumin in the urine) or estimated glomerular filtration rate (eGFR) value (i.e. kidney function).[1]

The CKD study adds to a growing body of real-world evidence from additional CaReMe studies across other cardio renal and metabolic diseases including heart failure and type 2 diabetes.[11-13]

AstraZeneca in CVRM
Cardiovascular, Renal and Metabolism (CVRM), part of BioPharmaceuticals, forms one of AstraZeneca's main disease areas and is a key growth driver for the Company. By following the science to understand more clearly the underlying links between the heart, kidneys and pancreas, AstraZeneca is investing in a portfolio of medicines for organ protection and improving outcomes by slowing disease progression, reducing risks and tackling co-morbidities. The Company's ambition is to modify or halt the natural course of CVRM diseases and potentially regenerate organs and restore function, by continuing to deliver transformative science that improves treatment practices and CV health for millions of patients worldwide.

AstraZeneca
AstraZeneca (LSE/STO/Nasdaq: AZN) is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialisation of prescription medicines in Oncology, Rare Diseases, and BioPharmaceuticals, including Cardiovascular, Renal & Metabolism, and Respiratory & Immunology. Based in Cambridge, UK, AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide. Please visit astrazeneca.com (http://www.astrazeneca.com/) and follow the Company on Twitter @AstraZeneca (https://twitter.com/AstraZeneca).

Contacts
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References

1. Sundström J, et al. Prevalence, outcomes, and cost of CKD in a contemporary population of 2.4 million patients from 11 countries: the CaReMe CKD Study. The Lancet Regional Health - Europe 2022;00: 100438. Published online 30 June 2022. Available from:  https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00132-6/fulltext

2. Chronic Kidney Disease Basics | Chronic Kidney Disease Initiative [Internet]. CDC. 2021; published online Sept 13. Available from: https://www.cdc.gov/kidneydisease/basics.html  

3. Golestaneh L, Alvarez PJ, Reaven NL, et al. All-cause costs increase exponentially with increased chronic kidney disease stage. Am J Manag Care 2017; 23: S163-72.

4. Bikbov B, et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017Global Burden of CKD. Lancet 2020; 395: 709-33.

5. Mennini FS, et al. Inside CKD: Projecting the Economic Burden of Chronic Kidney Disease Using Patient-Level Microsimulation. POSB68 ISPOR Europe 2021, Copenhagen, Denmark. Value in Health, 24(12);S2(December 2021):2021-11. Available from: https://www.ispor.org/heor-resources/presentations-database/presentation/euro2021-3408/112534

6. Jager KJ, et al. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant. 2019;34(11):1803-1805.

7. National Kidney Foundation [Internet]. Kidney Disease: Causes; 2015 [cited 2022 Jun 09]. Available from:  https://www.kidney.org/news/newsroom/fsindex

8. Centers for Disease Control and Prevention (CDC) [Internet]. Chronic Kidney Disease: Common - Serious - Costly; 2019 [cited 2022 Jun 24]. Available from: https://www.cdc.gov/kidneydisease/prevention-risk/CKD-common-serious-costly.html.

9. Centers for Disease Control and Prevention (CDC) [Internet]. Chronic kidney disease in the United States; 2021 [cited 2022 Jun 24]. Available from: https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html.

10. Briasoulis A, et al. Chronic kidney disease as a coronary artery disease risk equivalent. Curr Cardiol Rep. 2013;15(3):340.

11. Birkeland KI, et al. Lower cardiorenal risk with sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes without cardiovascular and renal diseases: A large multinational observational study. Diabetes Obes Metab 2021;23:75-85.

12. Birkeland KI, et al. Heart failure and chronic kidney disease manifestation and mortality risk associations in type 2 diabetes: A large multinational cohort study. Diabetes Obes Metab 2020;22:1607-1618.

13. Norhammar A, et al. Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: A multinational, observational study across 12 countries. Diabetes Obes Metab 2022;24:1277-1287.