Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain

Objectives: To describe the epidemiology, clinical profile, treatments, and to determine cardiovascular and renal outcomes after two years of follow-up in a contemporary chronic kidneay disease (CKD) population in Spain. This was also analyzed among the DAPA-CKD-like population (patients who met mos...

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Autores principales:	Carlos Escobar, Unai Aranda, Beatriz Palacios, Margarita Capel, Antoni Sicras, Aram Sicras, Antonio Hormigo, Roberto Alcázar, Nicolás Manito, Manuel Botana
Formato:	article
Lenguaje:	ES
Publicado:	Elsevier 2021
Materias:	DAPA-CKD Muerte Enfermedad renal crónica Hospitalización Medicación Eventos Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/0c0c2cddd7c04362bff12456f4d97a61
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record_format	dspace
institution	DOAJ
collection	DOAJ
language	ES
topic	DAPA-CKD Muerte Enfermedad renal crónica Hospitalización Medicación Eventos Diseases of the genitourinary system. Urology RC870-923
spellingShingle	DAPA-CKD Muerte Enfermedad renal crónica Hospitalización Medicación Eventos Diseases of the genitourinary system. Urology RC870-923 Carlos Escobar Unai Aranda Beatriz Palacios Margarita Capel Antoni Sicras Aram Sicras Antonio Hormigo Roberto Alcázar Nicolás Manito Manuel Botana Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
description	Objectives: To describe the epidemiology, clinical profile, treatments, and to determine cardiovascular and renal outcomes after two years of follow-up in a contemporary chronic kidneay disease (CKD) population in Spain. This was also analyzed among the DAPA-CKD-like population (patients who met most inclusion criteria of DAPA-CKD trial). Methods: Observational, retrospective, population-based study using BIG-PAC database. The CKD population was defined as patients ≥18 years, with at least one diagnostic code of CKD prior to the index date (January 1st, 2018). CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (CKD-EPI), or albuminuria >30 mg/g. Results: We identified 56,435 CKD patients after exclusions (76.4 years, 52.2% men, urine albumin-to-creatinine ratio 390.8 mg/g, eGFR 49.7 mL/min/1.73 m2). CKD prevalence was 4.91% and incidence 2.10 per 1000 patient-years. Regarding treatments, 69.2% were taking renin-angiotensin system inhibitors (only 4.2% at maximal doses) and 3.5% of diabetic patients SGLT-2 inhibitors. During the two years of follow-up, rates of heart failure, all-cause death, myocardial infarction, stroke, and CKD were 17.9, 12.1, 7.2, 6.3, and 5.9 events per 100 patient-years, respectively. During this period, 44% of patients were hospitalized, and 6.8% died during hospitalization. Cardiovascular outcomes were more common in the DAPA-CKD-like population. Conclusions: In Spain, CKD population is older and comorbidities, including diabetes and heart failure, are common. Cardiovascular and renal outcomes are frequent. There is room for improvement in CKD management, particularly through the use of drugs with proven cardiovascular and renal benefit. Resumen: Objetivos: Describir la epidemiología, el perfil clínico, los tratamientos y los eventos cardiovasculares y renales, tras 2 años de seguimiento en una población contemporánea con enfermedad renal crónica (ERC) en España. También se analizó en la población tipo DAPA-CKD (pacientes que cumplían la mayoría de criterios del estudio DAPA-CKD). Métodos: Estudio observacional, retrospectivo, poblacional, empleando la base de datos BIG-PAC. La población con ERC se definió como pacientes ≥ 18 años, con al menos un código diagnóstico de ERC antes de la fecha índice (01/01/2018). La ERC se definió como filtrado glomerular estimado (FGe) <60 ml/min/1,73 m2 (CKD-EPI) o albuminuria > 30 mg/g. Resultados: Se identificaron 56.435 pacientes con ERC, tras exclusiones (76,4 años, 52,2% varones, cociente albúmina-creatinina 390,8 mg/g, FGe 49,7 ml/min/1,73 m2). La prevalencia fue del 4,91% y la incidencia 2,10/1.000 pacientes/año. El 69,2% tomaba inhibidores del sistema renina-angiotensina (solo el 4,2% a dosis máximas) y el 3,5% de los diabéticos inhibidores SGLT-2. Tras 2 años, las tasas de insuficiencia cardiaca, muerte, infarto de miocardio, ictus y ERC fueron 17,9; 12,1; 7,2; 6,3; 5,9 eventos/100 pacientes/año, respectivamente. Además, el 44% hospitalizaron y el 6,8% murieron durante la hospitalización. Los eventos cardiovasculares fueron más frecuentes en la población tipo DAPA-CKD. Conclusiones: En España, la población con ERC es mayor, y las comorbilidades, incluyendo diabetes e insuficiencia cardiaca, comunes. Los eventos cardiovasculares y renales son frecuentes. Hay margen de mejora en el manejo de la ERC, especialmente a través del empleo de fármacos con beneficio cardiovascular y renal.
format	article
author	Carlos Escobar Unai Aranda Beatriz Palacios Margarita Capel Antoni Sicras Aram Sicras Antonio Hormigo Roberto Alcázar Nicolás Manito Manuel Botana
author_facet	Carlos Escobar Unai Aranda Beatriz Palacios Margarita Capel Antoni Sicras Aram Sicras Antonio Hormigo Roberto Alcázar Nicolás Manito Manuel Botana
author_sort	Carlos Escobar
title	Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
title_short	Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
title_full	Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
title_fullStr	Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
title_full_unstemmed	Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain
title_sort	epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in spain
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/0c0c2cddd7c04362bff12456f4d97a61
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spelling	oai:doaj.org-article:0c0c2cddd7c04362bff12456f4d97a612021-11-22T04:17:25ZEpidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain0211-699510.1016/j.nefro.2021.03.006https://doaj.org/article/0c0c2cddd7c04362bff12456f4d97a612021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0211699521001016https://doaj.org/toc/0211-6995Objectives: To describe the epidemiology, clinical profile, treatments, and to determine cardiovascular and renal outcomes after two years of follow-up in a contemporary chronic kidneay disease (CKD) population in Spain. This was also analyzed among the DAPA-CKD-like population (patients who met most inclusion criteria of DAPA-CKD trial). Methods: Observational, retrospective, population-based study using BIG-PAC database. The CKD population was defined as patients ≥18 years, with at least one diagnostic code of CKD prior to the index date (January 1st, 2018). CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 (CKD-EPI), or albuminuria >30 mg/g. Results: We identified 56,435 CKD patients after exclusions (76.4 years, 52.2% men, urine albumin-to-creatinine ratio 390.8 mg/g, eGFR 49.7 mL/min/1.73 m2). CKD prevalence was 4.91% and incidence 2.10 per 1000 patient-years. Regarding treatments, 69.2% were taking renin-angiotensin system inhibitors (only 4.2% at maximal doses) and 3.5% of diabetic patients SGLT-2 inhibitors. During the two years of follow-up, rates of heart failure, all-cause death, myocardial infarction, stroke, and CKD were 17.9, 12.1, 7.2, 6.3, and 5.9 events per 100 patient-years, respectively. During this period, 44% of patients were hospitalized, and 6.8% died during hospitalization. Cardiovascular outcomes were more common in the DAPA-CKD-like population. Conclusions: In Spain, CKD population is older and comorbidities, including diabetes and heart failure, are common. Cardiovascular and renal outcomes are frequent. There is room for improvement in CKD management, particularly through the use of drugs with proven cardiovascular and renal benefit. Resumen: Objetivos: Describir la epidemiología, el perfil clínico, los tratamientos y los eventos cardiovasculares y renales, tras 2 años de seguimiento en una población contemporánea con enfermedad renal crónica (ERC) en España. También se analizó en la población tipo DAPA-CKD (pacientes que cumplían la mayoría de criterios del estudio DAPA-CKD). Métodos: Estudio observacional, retrospectivo, poblacional, empleando la base de datos BIG-PAC. La población con ERC se definió como pacientes ≥ 18 años, con al menos un código diagnóstico de ERC antes de la fecha índice (01/01/2018). La ERC se definió como filtrado glomerular estimado (FGe) <60 ml/min/1,73 m2 (CKD-EPI) o albuminuria > 30 mg/g. Resultados: Se identificaron 56.435 pacientes con ERC, tras exclusiones (76,4 años, 52,2% varones, cociente albúmina-creatinina 390,8 mg/g, FGe 49,7 ml/min/1,73 m2). La prevalencia fue del 4,91% y la incidencia 2,10/1.000 pacientes/año. El 69,2% tomaba inhibidores del sistema renina-angiotensina (solo el 4,2% a dosis máximas) y el 3,5% de los diabéticos inhibidores SGLT-2. Tras 2 años, las tasas de insuficiencia cardiaca, muerte, infarto de miocardio, ictus y ERC fueron 17,9; 12,1; 7,2; 6,3; 5,9 eventos/100 pacientes/año, respectivamente. Además, el 44% hospitalizaron y el 6,8% murieron durante la hospitalización. Los eventos cardiovasculares fueron más frecuentes en la población tipo DAPA-CKD. Conclusiones: En España, la población con ERC es mayor, y las comorbilidades, incluyendo diabetes e insuficiencia cardiaca, comunes. Los eventos cardiovasculares y renales son frecuentes. Hay margen de mejora en el manejo de la ERC, especialmente a través del empleo de fármacos con beneficio cardiovascular y renal.Carlos EscobarUnai ArandaBeatriz PalaciosMargarita CapelAntoni SicrasAram SicrasAntonio HormigoRoberto AlcázarNicolás ManitoManuel BotanaElsevierarticleDAPA-CKDMuerteEnfermedad renal crónicaHospitalizaciónMedicaciónEventosDiseases of the genitourinary system. UrologyRC870-923ESNefrología, Vol 41, Iss 6, Pp 670-688 (2021)

Epidemiology, clinical profile, management, and two-year risk complications among patients with chronic kidney disease in Spain

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