High Unawareness of Chronic Kidney Disease in Germany

Abstract

Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular events, hospitalizations, end stage renal disease and mortality. Main risk factors for CKD are diabetes, hypertension, and older age. Although CKD prevalence is about 10%, awareness for CKD is generally low in patients and physicians, hindering early diagnosis and treatment. We analyzed baseline data of 3305 participants with CKD Stages 1–4 from German cohorts and registries collected in 2010. Prevalence of CKD unawareness and prevalence ratios (PR) (each with 95%-confidence intervals) were estimated in categories of age, sex, CKD stages, BMI, hypertension, diabetes and other relevant comorbidities. We used a log-binomial regression model to estimate the PR for CKD unawareness for females compared to males adjusting for CKD stage and CKD risk factors. CKD unawareness was high, reaching 71% (68–73%) in CKD 3a, 49% (45–54%) in CKD 3b and still 30% (24–36%) in CKD4. Prevalence of hypertension, diabetes or cardiovascular comorbidities was not associated with lower CKD unawareness. Independent of CKD stage and other risk factors unawareness was higher in female patients (PR = 1.06 (1.01; 1.10)). Even in patients with CKD related comorbidities, CKD unawareness was high. Female sex was strongly associated with CKD unawareness. Guideline oriented treatment of patients at higher risk for CKD could increase CKD awareness. Patient–physician communication about CKD might be amendable.

Chronic kidney disease awareness and its determinants in middle‐aged and older Japanese adults: Observations from a 5‐year follow‐up of the Uonuma cohort study

“…A number of studies have discussed sex differences regarding CKD prevalence and its prognosis, whereas those regarding CKD awareness are limited and inconsistent. The present study and some other studies found that men were more likely to be aware of CKD regardless of CKD stage than women, 22–26 but other studies reached different results 27,28 . This inconsistency may be due to differences in study populations and variations in CKD awareness questions.…”

Stage 5 Chronic Kidney Disease: Epidemiological Analysis in a NorthEastern District of Italy Focusing on Access to Nephrological Care

“…Kidney failure in older people is usually associated with other comorbidities such as dementia, cognitive impairment [25,26], chronic heart failure, cardiovascular disease [27,28], diabetes, and hypertension [1,2,29], which dominate the clinical picture in ageing people. CKD is an indolent disease, which can limit patients' awareness [30][31][32] and, likely, general practitioners' diagnoses. The rate of mortality in the whole population (27.6% of ESKD) is consistent with the data from the USRDS registry from 2018 [33], which reported 310 deaths for 1000 ESKD white patients over 75 years.…”

Underdiagnosed CKD in Geriatric Trauma Patients and Potent Prevention of Renal Impairment from Polypharmacy Risks through Individual Pharmacotherapy Management (IPM-III)

“…These diagnoses may already be outdated with gaps at the time of hospital admission. The unawareness of CKD even in advanced stages has been documented even more pronounced in various countries and medical disciplines [ 73 , 74 , 75 , 76 ]. Worldwide, only 6% of the general population and 10% of the high-risk population are reported to be aware of their CKD status, despite increasing CKD prevalence [ 75 ].…”