Chronic Kidney Disease Requiring Healthcare Services: A New Approach to Evaluate Epidemiology of Renal Disease

BACKGROUND Screening-based CKD estimates may not provide a sufficient insight into the impact of CKD on the use of healthcare resources in clinical practice. The aim of this study was to evaluate the epidemiology of "medicalized" CKD, that is, CKD requiring healthcare services, in an outpatient setting. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS This is a retrospective, longitudinal population-based study conducted in a large general practice setting in Southern Italy (Caserta) using a healthcare database. Over 2006-2011, all patients with a CKD diagnosis, either through CKD-related indications of use associated with drug prescriptions or through CKD-related hospital discharge diagnoses/procedures, were identified using this database. The prevalence of "medicalized" CKD in the general population of Caserta was estimated by age, gender, and calendar year. RESULTS Overall, 1,989 (1.3%) patients with a diagnosis of CKD were identified from 2006-2011 in the Caserta general population. The one year prevalence increased from 0.9% in 2006 to 1.6% in 2011, which is much lower compared to previous screening-based studies. The prevalence was slightly higher in males and increased significantly with advancing age (in 2011, 0.2% in ≤44 years old versus 9.2% in >80 years old). CONCLUSIONS The findings of this study suggest that, in the general population, the prevalence of "medicalized" CKD is lower compared to the screening-based CKD prevalence.