OBJECTIVES: Chronic kidney disease (CKD) is an underdiagnosed and undertreated disease, despite the availability of effective interventions. This study aimed to illustrate the clinical and socioeconomic benefits of increased diagnosis and improved adherence to guideline-directed medical therapies (GDMT) recommended for patients with CKD across countries with varying demographics, health system financing, and access-to-care.

METHODS: In three country settings (Australia, Brazil, and China), simulations were run for 25 years using the IMPACT CKD model to compare key clinical and socioeconomic outcomes between two scenarios: 25% increased diagnosis followed by 75% adherence to GDMT versus current practice. GDMT consisted of kidney protective therapies including glucose‑lowering, lipid‑lowering, antihypertensive, and lifestyle interventions. It was assumed that only patients with access-to-care could be diagnosed and treated, diagnosed patients could be treated with multiple therapies if eligible, and no guideline changes occurred over the time horizon. Treatment effects on estimated glomerular filtration rate decline, cardiovascular (CV) events, and acute kidney injury (AKI) events were assumed multiplicative.

RESULTS: Across the three countries, improved diagnosis, and adherence to GDMT was associated with 25-year cumulative decreases in dialysis, CV events, AKI events, and death by 46%-53%, 17%-28%, 8%-11%, and 5%-6%, respectively. Renal replacement therapy costs were projected to decrease by 39%-45%, with total costs decreasing by 1%-17%. Furthermore, delayed disease progression resulted in projected increases in net workdays, productivity, full-time equivalents, and tax revenue by 3%-8% among employed patients and caregivers. Differences in projected impacts between countries are multifactorial, though are sensitive to demographics and access-to-care.

CONCLUSIONS: This study predicted clinical and socioeconomic benefits from improved diagnosis and GDMT adherence across all three countries. These findings underscore the importance of policy implementation to achieve earlier CKD diagnosis and treatment optimization to reduce the detrimental impacts of CKD on patients, the healthcare system, and society.