CKD Prevalence Varies across the European General Population

Abstract

CKD prevalence estimation is central to CKD management and prevention planning at the population level. This study estimated CKD prevalence in the European adult general population and investigated international variation in CKD prevalence by age, sex, and presence of diabetes, hypertension, and obesity. We collected data from 19 general-population studies from 13 European countries. CKD stages 1-5 was defined as eGFR,60 ml/min per 1.73 m 2 , as calculated by the CKD-Epidemiology Collaboration equation, or albuminuria .30 mg/g, and CKD stages 3-5 was defined as eGFR,60 ml/min per 1.73 m 2 .CKD prevalence was age-and sex-standardized to the population of the 27 Member States of the European Union (EU27). We found considerable differences in both CKD stages 1-5 and CKD stages 3-5 prevalence across European study populations. The adjusted CKD stages 1-5 prevalence varied between 3.31% (95% confidence interval [95% CI], 3.30% to 3.33%) in Norway and 17.3% (95% CI, 16.5% to 18.1%) in northeast Germany. The adjusted CKD stages 3-5 prevalence varied between 1.0% (95% CI, 0.7% to 1.3%) in central Italy and 5.9% (95% CI, 5.2% to 6.6%) in northeast Germany. The variation in CKD prevalence stratified by diabetes, hypertension, and obesity status followed the same pattern as the overall prevalence. In conclusion, this large-scale attempt to carefully characterize CKD prevalence in Europe identified substantial variation in CKD prevalence that appears to be due to factors other than the prevalence of diabetes, hypertension, and obesity.

Unlocking the Value of Variation in CKD Prevalence

“…The study by Brück et al 7 suggests substantial geographic variation in CKD prevalence across Europe. For CKD stages 1-5, Brück et al 7 report overall adjusted prevalence ranging between 3.3% in Norway to .17% in northeast Germany.…”

“…6 The aging of the population combined with an epidemic-like increase in diabetes mellitus, obesity, and hypertension are anticipated to further drive substantial rises in CKD prevalence in the coming decades. 5 In this issue of the Journal of the American Society of Nephrology, Brück et al 7 report CKD prevalence across 13 European countries. Brück et al 7 leveraged the power of 19 studies designed to be representative of the adult general population; 10 restricted inclusion to subjects ages $65 years old.…”

“…5 In this issue of the Journal of the American Society of Nephrology, Brück et al 7 report CKD prevalence across 13 European countries. Brück et al 7 leveraged the power of 19 studies designed to be representative of the adult general population; 10 restricted inclusion to subjects ages $65 years old. The total study sample consisted of .225,000 people.…”

“…Brück et al 7 performed analyses on individual patient-level data, which optimized comparability of prevalence estimates between studies. It enabled application of a single definition for CKD on the basis of the same equation to estimate the GFR; the majority of studies also used the same assays for measuring serum creatinine (Jaffe) and urinary albumin (immunoassays).…”

“…It enabled application of a single definition for CKD on the basis of the same equation to estimate the GFR; the majority of studies also used the same assays for measuring serum creatinine (Jaffe) and urinary albumin (immunoassays). Brück et al 7 further increased comparability by adjusting overall prevalence estimates to a standard European age and sex distribution and repeating their analyses stratified for age and the main CKD risk factors: hypertension, diabetes, and obesity.…”