Findings have been released today from the study to date in Ireland to characterise the population affected by chronic kidney disease (CKD), over the age of 50 years. Trinity researchers analysed data from The Irish Longitudinal Study on Ageing in Ireland (TILDA), a nationally representative cohort study and conducted the research in collaboration with the Health Service Executive (HSE)
The presence and severity of CKD identifies individuals who are at increased risk of adverse health outcomes, including cardiovascular disease, premature death, and potentially progression to requiring dialysis or a kidney transplant and premature mortality; and as such, preventing and managing CKD constitutes a key aim of overall management.
Findings
- CKD prevalence in adults aged 50 years and over in Ireland is rising. While this is likely to be primarily related to ageing and improved survival in the general population, these trends highlight the importance of continued public health action to raise awareness and to improve the care and outcomes for people with CKD.
- CKD was present in 15.6% of people aged 50+ in Ireland, which equates to approximately 226,000 people or 1 in 7 of the population.
- 98% of people who had CKD were unaware they suffered from it.
- Whereas blood pressure management should be tightly controlled in CKD to prevent or slow down progression, blood pressure was poorly controlled in CKD in Ireland.
- CKD is becoming more common over time in Ireland, highlighting the need for action in primary and secondary care to raise awareness and to improve the outcomes for people living with CKD in Ireland.
- New cases of CKD in Ireland in people aged 50+ are occurring at a rate of 16 people per 1000 person-years of follow up which will likely also contribute to substantial future demand on Nephrology services and hospital inpatient stay now and in future.
- Hypertension was the most common CKD-related condition in the Irish adult population. The estimated prevalence of CKD in Irish adults aged 50+ years without diabetes and hypertension was 6.22 % based on Wave 1 data and 10.01% based on Wave 3 of TILDA. Age, blood pressure, HbA1c, BMI and hypertension were significantly associated with the presence and severity of CKD.
The increasing prevalence of CKD has implications for future treatment policies in nephrology in Ireland, including healthcare resource allocation planning as part of Sláintecare as well as the implications of new treatment options for CKD on the Chronic Disease Management Programs in Ireland.
New treatments proven in trials to alter the course of CKD thereby reducing progression to established kidney disease, are now also available for patients.
Recommendations
- Increased awareness of CKD is needed and of the adverse health outcomes associated with it including, cardiovascular disease, kidney failure and premature death.
- The incorporation of chronic kidney disease (CKD) into the HSE Chronic Disease Management Program for primary care may facilitate improved care of patients with CKD in Ireland.
- The introduction of medications known to reduce rates of deterioration in kidney function and reduce cardiovascular risk such as SGLT2 inhibitors, GLP-1 analogues, and non-steroidal mineralocorticoid antagonists where appropriate.
- Improve blood pressure control in people with CKD in Ireland based on international guideline targets and aim to manage their additional cardiovascular risk factors.
You can read a copy of the report [Chronic kidney disease in community-dwelling adults aged 50+ years – A report from TILDA and the National Renal Office] ] at this link: https://tilda.tcd.ie/publications/reports/CKDReport/
