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Chronic kidney disease (CKD) is a rapidly emerging global health crisis, with predictions of it being the fifth leading cause of death by 2040. Its rising prevalence is set to strain health systems, leading to significant economic implications; the proportion of the healthcare budget allocated to CKD treatment is projected to reach an average of 7.3% and up to 25.7% in some countries. IMPACT-CKD focuses on emphasizing the advantages of detecting and treating CKD early from a holistic standpoint. By offering a comprehensive assessment of a CKD patient’s journey, our aim is to provide insights and recommendations to effectively reduce the clinical, economic, societal, and environmental burdens associated with CKD.
The IMPACT-CKD model uses patient-level simulation, creating one million individual patients based on country population size. In this study, the model projected the impact of CKD from 2022–2032 in USA, Brazil, UK, Spain, Germany, The Netherlands, China, and Australia. The LSE CKD framework is built to map national and regional CKD treatment pathways and model the burden of CKD from health, socio-economic, and environmental perspectives. It covers the entire CKD pathway from primary care to end-of-life care, employing extensive validation and calibration to accurately represent known population data.
By 2032, 11.7–16.5% of the population in the abovementioned countries is expected to have CKD. Advanced-stage CKD is rising by >30% in Australia, China, The Netherlands, and Spain during 2022–2032. Dialysis requirements will increase by >75% across all eight countries. Financial- and resource-related implications are over 77% increase in renal replacement therapy (RRT) costs in all eight countries and over 23% increase in the number of CKD-associated ER visits and hospitalizations in seven of the above countries. These increases are due to increased number of patients requiring late-stage CKD treatment in the next decade. Economic productivity will be significantly impacted, with projections showing 2.85 billion missed workdays due to patient absenteeism and 327 million missed workdays due to caregiver absenteeism across the eight countries over the next 10 years, resulting in a loss of 37 billion USD in tax revenue across all the countries. The environmental impact projections for 2032 across these countries indicate 440 million m3 of freshwater consumption, 11 billion kg oil eq. of fossil fuel use, and 29 billion kg CO2 eq. of carbon use, equating to annual water usage of ~2.7 million households, power for ~149.7 million lightbulbs, and CO2 emissions of ~17.3 million cars, respectively (Table).
The IMPACT CKD analysis reveals exponential and varied burdens of CKD across diverse countries. Study insights emphasize an urgent need for tailored, sustainable interventions, addressing clinical and economic consequences, and substantial and escalating environmental impact associated with end-stage CKD treatments. These consequences, including significant freshwater consumption, fossil fuel use, and carbon emissions, are integral considerations in developing holistic and effective strategies for CKD management, pushing global discourse towards an environmentally conscious and equitable approach to combatting the multifaceted challenges of CKD.