ABSTRACT Aim To describe 5‐year outcomes of chronic kidney disease (CKD) in a large, population‐based cohort in Western Australia, including rates of progression, regression, kidney failure and death. Background CKD is a major public health challenge associated with increased morbidity and mortality, yet the natural history of early‐stage disease in population settings remains poorly defined. Methods We conducted a retrospective cohort study using linked pathology and hospital data for adults with incident CKD between 2006 and 2022. CKD stage was defined by two estimated glomerular filtration rate (eGFR) values ≥ 3 and < 12 months apart: mild (45–59), moderate (30–44) and severe (15–29) mL/min/1.73 m 2 . Outcomes were assessed over 5 years using a competing risks framework. Results Among 153 527 individuals with incident CKD during the study period (mean age 75.6 years, 52.6% women) 118 248 had mild, 58 323 moderate and 20 322 severe CKD. At 5 years, death occurred in 16.8% (mild), 26.7% (moderate) and 30.5% (severe); kidney failure occurred in 0.6%, 2.5% and 30.0%, respectively. CKD progression was more common than regression in mild (20.1% vs. 11.8%) and moderate (18.9% vs. 14.5%) disease. Albuminuria testing was recorded in < 35% of patients. Conclusion People with early‐stage CKD face substantial risks of progression, kidney failure and death within 5 years. The low rate of albuminuria testing suggests missed opportunities for early identification of high‐risk individuals and timely intervention. Enhancing CKD detection and monitoring in primary care may improve outcomes.
Thomas et al. (Sun,) studied this question.
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