Baseline Characteristics of the DISCOVER CKD Prospective Cohort

Carol Pollock; Juan-Jesus Carrero; Eiichiro Kanda; Richard Ofori-Asenso; Hungta Chen; Juan Jose Garcia Sanchez; Surendra Pentakota; Roberto Pecoits-Filho; Steven Fishbane; Carolyn S P Lam; Naoki Kashihara; David C Wheeler

doi:10.1007/s12325-024-03028-z

Baseline Characteristics of the DISCOVER CKD Prospective Cohort

Adv Ther. 2024 Nov 29. doi: 10.1007/s12325-024-03028-z. Online ahead of print.

Authors

Affiliations

¹ Kolling Institute, Royal North Shore Hospital, University of Sydney, 10 Westbourne St, St Leonards, Sydney, NSW, 2064, Australia. carol.pollock@sydney.edu.au.
² Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
³ Department of Health Data Science, Kawasaki Medical School, Kurashiki, Okayama, Japan.
⁴ Cardiovascular, Renal, Metabolism Epidemiology, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
⁵ Medical and Payer Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
⁶ Global Market Access and Pricing, AstraZeneca, Barcelona, Spain.
⁷ Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
⁸ School of Medicine, Pontifical Catholic University of Parana, Curitiba, Brazil.
⁹ Arbor Research Collaborative for Health, Ann Arbor, MI, USA.
¹⁰ Division of Nephrology, Zucker School of Medicine, Great Neck, NY, USA.
¹¹ National Heart Centre Singapore, Singapore, Singapore.
¹² Duke National University of Singapore, Singapore, Singapore.
¹³ Department of Nephrology, Kawasaki Medical School, Okayama, Japan.
¹⁴ Department of Renal Medicine, University College London, London, UK.

PMID: 39611870
DOI: 10.1007/s12325-024-03028-z

Abstract

Introduction: Real-world data from patients with chronic kidney disease (CKD) are limited, particularly regarding clinical management, treatment patterns and health-related quality of life (HRQoL) in the context of new therapies and updated standard of care guidelines.

Methods: DISCOVER CKD is an observational cohort study enrolling adult patients with CKD, defined by an International Classification of Diseases, 10th Revision code, or with two estimated glomerular filtration rate measures < 75 ml/min/1.73 m² recorded 91-730 days apart. We describe the demographics, baseline characteristics and patient-reported outcomes of patients enrolled in the prospective phase.

Results: Of 1052 patients (mean age 62.5 years; 36.9% female) enrolled from the USA, UK, Spain, Italy, Sweden and Japan, 727 (69.1%) had stage 2-3b CKD and 325 (30.9%) had stage 4-5 CKD. Overall, 72.4%, 43.0% and 37.5% of patients had histories of hypertension, diabetes and hyperlipidaemia, respectively. In total, 58.7% and 14.0% were receiving renin-angiotensin-aldosterone system inhibitors (RAASi) and sodium-glucose co-transporter 2 inhibitors (SGLT2i), respectively. Compared with patients with stage 2-3b CKD, patients with stage 4-5 CKD reported numerically greater symptom burden across all 11 symptoms measured, numerically worse HRQoL across all eight categories measured using the 36-item Short Form (SF-36) questionnaire, and numerically greater impairment at work across all four categories measured using the Work Productivity and Activity Impairment chronic kidney disease (WPAI-CKD) questionnaire. Compared with patients with stage 2-3b CKD, a higher proportion of patients with stage 4-5 CKD had anaemia, hyperkalaemia and oedema (49.8% vs. 16.9%, 21.8% vs. 8.4% and 17.5% vs. 9.5%, respectively).

Conclusions: These contemporary real-world data from six countries highlight the substantial symptom, medication and psychosocial burden associated with CKD, and continued gaps in treatment. Graphical abstract available for this article.

Trial registration: ClinicalTrials.gov identifier, NCT04034992.

Keywords: Baseline characteristics; Chronic kidney disease; DISCOVER CKD; Epidemiology; Patient-reported outcomes.

Associated data

ClinicalTrials.gov/NCT04034992