A new University of Zürich (UZH) study shows that the screening and treatment of patients with kidney disease in Switzerland is unsatisfactory.1 The study suggests that two thirds of patients are not diagnosed.2 Women are particularly affected. Optimized early detection and treatment improves patients’ quality of life and leads to significant cost savings of up to 250,000 Swiss francs per year per patient.3
Chronic kidney disease (CKD) often worsens without being noticed. Targeted early detection and treatment can prolong the period before dialysis or renal transplantation is required. In Switzerland, chronic kidney disease affects one out of every ten adults.4,5 A new University of Zürich (UZH) study found deficiencies in the early detection and treatment of chronic kidney disease in the Swiss population. Testing for protein in the urine (albuminuria) or the targeted examination of high-risk patients is frequently missed. Detection and treatment of CKD in women is particularly unsatisfactory.
Awareness-raising measures are necessary for early detection of CKD
Lead investigator Dr med. Levy Jäger explains: “The results underscore the need for awareness-raising measures. This permits ameliorating the identified deficiencies in medical practice so that early detection and treatment intertwine optimally in the future. This will improve the lives of those affected and lower health care costs.”
Information portals such as nieren-leiden-leise.ch and diagnose-niereninsuffizienz.ch attempt to promote public awareness and offer guidance. Additionally, the Swiss Society of Nephrology (swissnephrology.ch) has developed guidelines to support medical practitioners in the identification, early detection and treatment of chronic kidney disease.
Various options for testing and treatment are available
Prof. Dr med. Thomas Rosemann PhD, Director of the Institute for Family Medicine at the University of Zürich, adds: “Early diagnosis and intervention of CKD is critical for positively influencing the course of the disease. Today, there are already a number of different tests and treatment options available. For example, it is possible to accurately test for albuminuria. In patients who are at an increased risk for kidney damage, it is recommended to monitor kidney function once every year.”
Experts agree: Early recognition of kidney disease is important in order to improve the quality of life of those affected. At the same time, improved treatment standards lead to significant cost savings for the Swiss healthcare system. Estimates suggest a savings potential of 250,000 Swiss francs per year per patient requiring dialysis.3
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Chronic Kidney Disease (CKD)
CKD is a severe progressive illness that affects almost 10 percent of adults in Switzerland.4,5 CKD is defined by reduced kidney function. The most common causes of CKD are diabetes, hypertension, and glomerulonephritis.4,6 CKD is associated with considerable morbidity for patients and an increased risk for cardiovascular events such as heart failure (HF) and premature death.7 In its most advanced and severe stage, known as ESKD (end-stage kidney disease), kidney damage and deterioration of kidney function has progressed to a point that requires dialysis or kidney transplantation.8
About the University of Zürich (UZH) study
The UZH study, “Quality and variation of care for chronic kidney disease in Swiss primary care practice: A retrospective database study”, sponsored by AstraZeneca Switzerland, examined 14 quality indicators in the care of CKD using electronic medical records data from Swiss general medicine practices from 2013 to 2019. The data was obtained through the FIRE database (more about the FIRE project below).
The study explored two patient cohorts from 483 primary care practitioners. One cohort was chosen to evaluate kidney function in patients with predisposing illnesses (n = 47,201, average age 68 years, 48.7 percent female) The second part of the study examined the care of a cohort of patients with laboratory-confirmed CKD (n = 14,654, average age 80 years, 57.5% female).
Authors
Jäger L, Rosemann T, Burgstaller JM, Senn O, Markun S (2022) Quality and variation of care for chronic kidney disease in Swiss general practice: A retrospective database study.
PLoS ONE 17(8):e0272662. https://doi.org/10.1371/journal.pone.0272662.
The FIRE Project – Electronic Documentation and Research in Primary Care Medicine
In 2009, under the direction of Prof. Dr med. Thomas Rosemann (PhD), the University of Zürich Institute for Family Medicine initiated the FIRE Project (“Family medicine research using electronic medical records”). The objective of the FIRE Project is to document and improve the quality of care in family medicine.
Further information about the FIRE Project: www.fireproject.ch
University of Zürich (UZH) Institute for Family Medicine
The Institute’s mission is to familiarize medical students with the work and tasks of the family practitioner. The research investigates innovative approaches to diagnosis and treatment in primary care practice that are targeted at improving patients’ quality of life.
Further information on the Institute for Family Medicine: www.hausarztmedizin.uzh.ch
AstraZeneca in Switzerland
AstraZeneca is a global pharmaceutical company headquartered in Great Britain that has been active in Switzerland for almost 50 years. The company is among the ten largest pharmaceutical firms in Switzerland and is involved in the following therapy areas: oncology, respiratory diseases and immunology, cardiovascular, renal and metabolic diseases, as well as vaccines and immunotherapy, which also includes medications to combat Covid‑19. The primary aim of the over 250 staff members is to make new medicines available to patients as rapidly as possible. In Switzerland, more than 250,000 individuals are under treatment with an AstraZeneca medication. By 2025, the firm anticipates licensing over 40 new therapies. AstraZeneca is committed to the goal of making the Swiss health care system more sustainable and resilient. In order to honour its commitment to a healthy planet and a healthy population, the company is working tirelessly to reduce CO2 emissions and waste products. Thus, it has set a target for itself to come carbon-negative by 2030.
Further information about AstraZeneca Switzerland: www.astrazeneca.ch
References
1. Jäger L, et al. (2022) Quality and variation of care for chronic kidney disease in Swiss general practice: A retrospective database study.PLoS ONE 17(8):e0272662. Available from: https://doi.org/10.1371/journal.pone.0272662 .
2. Sundström J, et al. Prevalence, outcomes, and cost of CKD in a contemporary population of 2.4 million patients from 11 countries: the CaReMe CKD Study. The Lancet Regional Health – Europe 2022;00: 100438. Published online 30 June 2022. Available from: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00132-6/fulltext
3. Pierre-Yves Martin. Fortschritte in der Nephrologie: Vorteilhaft für Patienten und Kosten.[Advances in nephrology: benefits for patients and costs] Schweizerische Ärztezeitung. [Swiss Medical Journal] 2017; 98(45):1484–1486.
4. Ogna VF, et al., Prevalence and determinants of chronic kidney disease in the Swiss population. Swiss Med Wkly. 2016;146:w14313.
5. Ponte B. et al. Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis. Nephrol Dial Transplant. 2013 Sep;28(9):2329-39.
6. National Kidney Foundation [Internet]. Kidney Disease: Causes; 2015 [cited 2022 Jun 09]. Available from: https://www.kidney.org/news/newsroom/fsindex
7. Centers for Disease Control and Prevention (CDC) [Internet]. Chronic Kidney Disease: Common - Serious - Costly; 2019 [cited 2022 Jun 24]. Available from: https://www.cdc.gov/kidneydisease/prevention-risk/CKD-common-serious-costly.html.
8. Centers for Disease Control and Prevention (CDC) [Internet]. Chronic kidney disease in the United States; 2021 [cited 2022 Jun 24]. Available from: https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html.
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CH-6811 / November 2022