PROGRAM FOR EARLY DETECTION AND MANAGEMENT OF CHRONIC KIDNEY DISEASE – CROATIAN MODEL

 

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PROGRAM FOR EARLY DETECTION AND MANAGEMENT OF CHRONIC KIDNEY DISEASE – CROATIAN MODEL

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Ivan
Bubić
Mario Laganović mlaganovic@gmail.com University Hospital Merkur Department of nephrology Zagreb Croatia -
Nataša Ban Toskić natasa.bantoskic@gmail.com General practice dr Nataša Ban Toskić Zagreb Center Zagreb Croatia -
Jadranka Karuza adra1312@gmail.com General practice dr Jadranka Karuza Department of Family Medicine, School of Medicine Rijeka Croatia -
Ksenija Vučur ksenija_vucur@hotmail.com University Hospital Merkur Department of nephrology Zagreb Croatia -
Karla Boras karla.boras@gmail.com University Hospital Merkur Department of nephrology Zagreb Croatia -
Tamara Knežević knezevic.tamara23@gmail.com University Hospital Merkur Department of nephrology Zagreb Croatia -
Bojana Šimunov bojana.simunov@gmail.com University Hospital Merkur Department of nephrology Zagreb Croatia -
Ivan Bubić bubic.ivan@gmail.com University Hospital Center Rijeka Department of Nephrology, Dialysis and Kidney Transplantation Rijeka Croatia *
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 Chronic kidney disease (CKD) affects approximately 10% of the global population and is expected to rise further due to increasing rates of diabetes, hypertension, and obesity. Early detection at the primary care level is crucial to prevent disease progression and reduce associated morbidity, mortality, and economic burden. This study presents the model and first national results of the Croatian Early Detection and Management Program for CKD, implemented through a novel digital tool – the Chronic Kidney Disease Preventive Panel – integrated into primary care electronic health records.

 The Croatian Society of Nephrology, Dialysis and Transplantation, in collaboration with the Association of Croatian Family Physicians, launched the CKD Preventive Panel to standardize CKD screening, staging, and management in alignment with KDIGO guidelines. Panel represent an interactive, innovative, digital tool for detecting, monitoring and standardizing comprehensive care of patients with CKD on primary care physician (PCP) level through interactive interface depending on the degree of renal disfunction according to the latest KDIGO guidelines.The tool was implemented in 2,300 family medicine practices, enabling systematic collection of demographic, clinical, and laboratory data of high risk population (diabetic, hypertensive and obese population) and providing automated risk stratification with management recommendations.

 From May 2024 to April 2025, 19 045 patient records were recorded (47% male, 53% female) with monthly screening average 1587 patients. CKD was predominantly identified in early stages: G1 (25.5%), G2 (40.3%), and G3a (18.7%). Hypertension was present in 90.5% of cases, diabetes in 43.4%, and obesity in 34.5%. Albuminuria testing (ACR) was performed in only 23% of patients, indicating a key area for improvement. Average eGFR was 75.5 ml/min/1.73 m², and 24.5% of patients had eGFR <60 ml/min/1.73 m². Based on automated recommendations, 93% of patients were recommended to be followed up by primary care physician, while 7% were referred to nephrologist. Newly diagnosed CKD was identified in 33.9% of patients. The Panel also showed how it is being used across Croatian counties and highlighted where more education is needed to improve CKD screening .

 This program represents the first nationwide, structured approach to early CKD detection in Croatia, demonstrating high engagement from PCPs. Primary care physicians screened more patients than expected, likely because the Panel is simple and easy to use, helping them manage kidney patients faster with clear guidelines and reducing their workload. The CKD Preventive Panel has proven to be an effective and user-friendly tool, enabling standardized patient management and improving recognition of early disease stages. While gaps remain—particularly in albuminuria testing—the program lays the foundation for improved patient outcomes and provides a scalable model for CKD prevention and management.

Kewords