OBJECTIVES: Chronic kidney disease (CKD) represents a significant cause of morbidity and mortality. Renal replacement therapy (RRT) in later-stages is both costly and diminishes quality of life for patients and caregivers. Public health and policy planning should encompass the broader burden of CKD, considering its human, societal, and environmental burden alongside clinical and economic aspects. This study aims to comprehensively quantify the burden of CKD in Spain.

METHODS: IMPACT CKD, a patient-level simulation model, was developed to simulate CKD progression while incorporating the impact of acute kidney injury, cardiovascular events, and comorbidities. CKD status was determined by assigning estimated glomerular filtration rate (eGFR) and albuminuria levels. Clinical progression was predicted based on the annual rate of eGFR decline. The model was used to forecast the 10-year impact of CKD in Spain. Validation against population data and calibration to historical CKD and RRT trends were performed to minimize uncertainty.

RESULTS: From 2022 to 2032, the prevalence of CKD in Spain is projected to increase from 13.1% to 15.4%, with the number of affected individuals rising from 6.2 to 7.2 million. Substantial increases are projected in the number of stage 3-5 CKD patients (57.9%) and patients receiving RRT (45.6%) over this period. The increase in late-stage CKD is also associated with increased annual RRT costs from €1.88 to €2.74 billion. Alongside the escalating clinical and economic burden, CKD is predicted to have adverse environmental and societal impacts. Over the next decade, projected contributions include 18.9 billion kg of CO₂ emissions and 32.6 million missed workdays due to absenteeism among CKD patients.

CONCLUSIONS: The IMPACT CKD model provides valuable insights into the growing number of late-stage CKD patients in Spain over the next decade. To mitigate this burden, improved screening and treatment strategies, emphasizing disease progression delay, and RRT resource planning are imperative.