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
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引用次数: 0
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.
来自慢性肾脏疾病（CKD）患者的真实世界数据有限，特别是在新疗法和更新的护理标准指南背景下，关于临床管理、治疗模式和健康相关生活质量（HRQoL）的数据。方法：DISCOVER CKD是一项观察性队列研究，纳入国际疾病分类第10版代码定义的CKD成年患者，或间隔91-730天记录的两项肾小球滤过率估计。我们描述了在前瞻性阶段入组的患者的人口统计学、基线特征和患者报告的结果。结果：1052例患者(平均年龄62.5岁；36.9%女性)来自美国、英国、西班牙、意大利、瑞典和日本，727例（69.1%）为2-3b期CKD， 325例（30.9%）为4-5期CKD。总体而言，72.4%、43.0%和37.5%的患者有高血压、糖尿病和高脂血症病史。总的来说，58.7%和14.0%的患者分别接受肾素-血管紧张素-醛固酮系统抑制剂（RAASi）和钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）。与2-3b期CKD患者相比，4-5期CKD患者在所有11种症状中报告的症状负担在数值上更大，使用36项短表（SF-36）问卷测量的所有8个类别的HRQoL在数值上更差，使用工作效率和活动损害慢性肾脏疾病（WPAI-CKD）问卷测量的所有4个类别的工作损害在数值上更大。与2-3b期CKD患者相比，4-5期CKD患者出现贫血、高钾血症和水肿的比例更高（分别为49.8% vs. 16.9%、21.8% vs. 8.4%和17.5% vs. 9.5%）。结论：这些来自六个国家的当代真实世界数据突出了与CKD相关的实质症状，药物和心理社会负担，以及治疗方面的持续差距。本文提供图形摘要。试验注册：ClinicalTrials.gov识别码，NCT04034992。
期刊介绍：
Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged.
The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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