Key result
Stage 3 CKD remains unrecorded in up to ~97% of laboratory-confirmed patients across five countries.
Why the study?
Recording a CKD diagnosis is associated with improved monitoring and outcomes, but the prevalence of unrecorded stage 3 CKD in administrative databases needed to be estimated.
What is the prevalence of unrecorded stage 3 CKD in patients with laboratory evidence of the disease across multiple countries?
Observational (n=238,308)
Yes
What is the prevalence of unrecorded stage 3 CKD in patients with laboratory evidence of the disease across multiple countries?
More than half of patients with laboratory evidence of stage 3 CKD lack a formal diagnosis code in their medical records across multiple countries, highlighting a major gap in disease recognition and potential missed opportunities for disease-modifying therapy.
High unrecorded stage 3 CKD prevalence signals documentation gaps; hypothesis-generating for targeted screening and recording interventions.
Background: Chronic kidney disease (CKD) is a global public health concern, affecting approximately 850 million people worldwide. Guidelines recommend early identification and management of CKD to mitigate disease progression and delay the onset of complications. Recording a CKD diagnosis in medical records is associated with improved kidney function and blood pressure monitoring, better use of disease‐modifying therapy, and reduced risk of CKD progression. REVEAL‐CKD is a multinational, observational study that aims to estimate the prevalence of stage 3 CKD which is unrecorded in administrative databases. Methods: Data were extracted from country‐specific databases of patient medical records in Australia, Brazil, Canada, England, and Spain. Included patients (aged ≥ 18 years) had two consecutive estimated glomerular filtration rate (eGFR) measurements between 30 and < 60 mL/min/1.73 m 2 taken 91–730 days apart. Patients were considered to have unrecorded CKD if they had no CKD diagnosis code (any stage) at any time before and up to 6 months after study index (date of second qualifying eGFR). Results: Across countries, median age was 72–78 years, median eGFR was 46.5–53.5 mL/min/1.73 m 2 , and availability of urinary albumin—creatinine ratio testing ranged from 4.9% (Brazil) to 53.5% (Canada). The prevalence of unrecorded stage 3 CKD was 90.0% (1002/1113 patients) in Australia, 97.0% (10,925/11,262) in Brazil, 92.0% (42,226/45,914) in Canada, 56.9% (84,237/148,153 in England, and 84.8% (27,035/31,866) in Spain. Conclusions: More than half of the patients with laboratory evidence of stage 3 CKD lacked a CKD diagnosis code in all countries examined. Substantial intercountry variations in rates of CKD recording and testing were observed. International sharing of best practice guidance, systematic changes to improve data quality, and increased awareness of the importance of timely coding among healthcare professionals will help to improve accurate recording of stage 3 CKD. Trial Registration: ClinicalTrials.gov identifier: NCT04847531 .
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Pecoits‐Filho et al. (2024) conducted an observational in Stage 3 Chronic Kidney Disease (n=238,308). Laboratory evidence of stage 3 CKD was evaluated on Prevalence of unrecorded stage 3 CKD. Among patients with laboratory evidence of stage 3 CKD across five countries, the prevalence of unrecorded CKD diagnosis was high, ranging from 56.9% in England to 97.0% in Brazil.
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