Burden of Chronic Kidney Disease by KDIGO Categories of Glomerular Filtration Rate and Albuminuria: A Systematic Review
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REVIEW
Burden of Chronic Kidney Disease by KDIGO Categories of Glomerular Filtration Rate and Albuminuria: A Systematic Review Molly Murton . Danielle Goff-Leggett . Anna Bobrowska . Juan Jose Garcia Sanchez . Glen James . Eric Wittbrodt . ¨ rstadius . Roberto Pecoits-Filho . Stephen Nolan . Elisabeth So Katherine Tuttle Received: October 13, 2020 / Accepted: November 10, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: The Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines recommend classifying patients by glomerular Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12325020-01568-8) contains supplementary material, which is available to authorized users. M. Murton D. Goff-Leggett A. Bobrowska Costello Medical Consulting Ltd, Cambridge, Cambridgeshire, UK J. J. Garcia Sanchez (&) G. James S. Nolan AstraZeneca, Cambridge, Cambridgeshire, UK e-mail: [email protected] E. Wittbrodt AstraZeneca, Washington DC, USA ¨ rstadius E. So ¨ lndal, Gothenburg, Sweden AstraZeneca, Mo R. Pecoits-Filho Arbor Research Collaborative for Health, Ann Arbor, MI, USA R. Pecoits-Filho School of Medicine, Pontifical Catholic University of Parana´, Curitiba, Parana´, Brazil K. Tuttle Providence Health Care, Spokane, WA, USA K. Tuttle Division of Nephrology, Kidney Research Institute and Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
filtration rate (GFR) and albuminuria to predict chronic kidney disease (CKD) prognosis. The aim of this systematic review was to explore the epidemiological burden of CKD stratified by the KDIGO 2012 categories. Methods: MEDLINEÒ and Embase were searched for observational studies of patients with CKD with results stratified according to the KDIGO 2012 classification. Investigated outcomes were prevalence, incidence, and risk factors and complications of CKD, including mortality. Results: The review included ten observational studies with 3033 to 46,949 participants, conducted in the USA, China, France, Italy and Spain. The most frequently reported outcome was the prevalence of CKD (GFR categories G3–5), ranging from 2% to 17%. Most participants were normoalbuminuric, with 0.4–3.2% macroalbuminuric, and most fell within the KDIGO 2012 low-risk or moderate-risk groups, with 0.9–5.6% in the high-risk and 0.3–4.8% in the very high-risk groups. Although scarce, data on the prevalence of comorbidities in CKD according to the KDIGO classification suggest that they increase with albuminuria severity. Conclusions: Patients with CKD frequently have complications, but only a small proportion have severely increased albuminuria or fall within the KDIGO high-risk or very high-risk groups. These groups, however, are associated with the highest burden of disease, as comorbidities are more prevalent with increasing
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albuminuria severity. New studies framed by the KDIGO 2012 classification are needed to address key gaps in the understanding of CKD burden and outcomes. Keywords: Albuminu
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