Chronic kidney disease
Our aim is to help prevent, slow and treat disease progression, while addressing life-threatening complications such as anaemia and hyperkalaemia.
Chronic kidney disease (CKD) is a progressive disease that can eventually lead to kidney failure, also called end-stage kidney disease (ESKD). Worldwide, nearly 700 million people are affected by CKD,1 with likely many more still being undiagnosed.2,3 The main causes of CKD are diabetes, high blood pressure and glomerulonephritis.4
CKD and its comorbidities
CKD is bi-directionally linked with heart failure, meaning worsening of one condition induces worsening of the other.5 CKD patients also face an increased risk of developing other complications like anaemia or hyperkalaemia,6,7 both associated with increased mortality.8,9
Anaemia of CKD
Anaemia is a condition occurring in people with CKD in which the body doesn’t produce enough healthy red blood cells.10 Anaemia of CKD is associated with an increased risk of hospitalisation, cardiovascular events and death.11,12 It also frequently causes fatigue, cognitive impairment and reduced quality of life.11-13 Furthermore, it is well-established that anaemia in CKD increases the risk of cardiovascular disease, hospitalisation and mortality if not effectively managed.9,14
Opening the discussion on anaemia of CKD
Understanding current levels of patients’ awareness, and the emotional and physical impacts of anaemia of CKD, is an important first step to improved treatment and care for patients with CKD. Therefore, we commissioned a survey of 500 CKD patients in the US and 500 patients in China to identify gaps or opportunities for providing stronger patient support and ultimately improving outcomes.
CKD and hyperkalaemia
As kidney function declines, the kidneys are less able to remove potassium from blood.15 This can lead to hyperkalaemia, or elevated levels of potassium in the blood. Hyperkalaemia is a common complication in CKD, affecting up to 40-50% of patients.16 It is associated with an increased risk of cardiovascular events and death.8,17,18 Patients with hyperkalaemia are often asked to make significant lifestyle changes, including adopting strict low-potassium diets.19
Addressing CKD and other CVRM diseases
Science is uncovering the commonalities between cardiovascular, renal and metabolic diseases (CVRM) which is at the core of our approach towards holistic care for CVRM patients. We aim to continue developing our potential solutions to these life-altering diseases that will not only bring kidney diseases to the medical forefront, but also offer patients new methods to improve their health journey beyond one specific disease.
The patient experience
Kidney disease is exhausting in its end stage. I go to the clinic three times a week and each dialysis appointment takes hours.
Chronic kidney disease
CKD patients may face physical and emotional difficulties on a daily basis. The progressive nature of CKD alongside the knowledge that no cure exists can often be a challenging journey for both patients and their loved ones.20,21
Early diagnosis and intervention have been shown to slow progression of CKD and improve patient outcomes22 – but with typically no symptoms in the early stages,20 patients may not realise they have the disease until it has advanced. In these later stages, patients face the risk of developing other complications and dialysis possibly looming on the horizon.21
Nearly 700 million
people are living with CKD worldwide1
countries across the world, 2-3% of the annual healthcare budget is spent on ESKD treatment23
of Stage 5 CKD patients have anaemia in the US12
Up to 40-50%
of patients with CKD may at some stage be affected by hyperkalaemia16
disease accounts for up to 30% of deaths in patients with CKD24.
Today, we are focused on exploring treatments and solutions across the full continuum of care, from prevention and protection before a CKD diagnosis to slowing progression and managing serious complications across all stages of disease after diagnosis.
Collaborating with Antaros Medical for innovative CKD solutions
We’ve partnered with Antaros Medical, a company pioneering renal magnetic resonance imaging (MRI) for drug development, to investigate predictive biomarkers for use in CKD diagnosis, treatment response and drug development. Our collaboration includes research showing the potential of MRI as a non-invasive tool to assess the kidneys, and in addition, a recent study (HEROIC) which reviews imaging, biopsy and sampling techniques to identify novel markers of renal decline and explore the pathological development of diabetic kidney disease and its progression.25
Generating real-world evidence on the clinical management and experiences of patients with CKD
DISCOVER CKD is a study on patients with CKD to assess treatment experience and patterns, effect of the treatment, patient outcomes and patient quality of life. This international observational cohort study is comprising both prospective and retrospective cohorts with the aim to evaluate, using real-world data, contemporary management of CKD to provide insights into current gaps in treatment, management and quality of life in patients with CKD. Insights from DISCOVER CKD are helping inform our approach to CKD therapy development and providing us with a deeper understanding of what living with CKD in the real-world in like.26
Partnering with KDIGO to advance CKD care
We continuously seek out collaborations with partners that may help us improve patient outcomes and positively impact the continuum of CKD care. In 2019, we formalised a multi-year, cross-portfolio agreement with Kidney Disease: Improving Global Outcomes (KDIGO), the leading global organisation for practice-based kidney disease guidelines. Our partnership with KDIGO aims to directly address unmet needs related to the progression of CKD, hyperkalaemia, anaemia and other co-morbidities of CKD. Through the partnership with KDIGO, we are working together to advance clinical dialogue on optimal patient care through the development of educational sessions, early detection tools, and publications.
Nephrologists discuss the unmet clinical need in CKD
To better understand the current gaps in managing CKD and its complications, we work with leading nephrologists around the world. From their perspectives on CKD and its complications to their views on the future of renal patient care, nephrologists have commented on various challenging aspects of this complex patient. Watch one of our videos with Dr. Bicheng Liu here or click this link to view the full video collection with our partner nephrologists on YouTube.
With chronic kidney disease affecting nearly 700 million people worldwide, I am proud that AstraZeneca is taking the lead and is fully committed to building a portfolio that will establish us as a scientific leader in the cardiorenal space.
Discover more about CVRM
- Bikbov B et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2020; 395(10225):709–33.
- National Kidney Foundation. Kidney Disease: The Basics; 20 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/news/newsroom/factsheets/KidneyDiseaseBasics.
- Hirst JA et al. Prevalence of chronic kidney disease in the community using data from OxRen: A UK population-based cohort study. Br J Gen Pract 2020; 70(693):e285-e293.
- National Kidney Foundation. Kidney Disease: Causes; 2020 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/atoz/content/kidneydiscauses.
- House AA et al. Heart failure in chronic kidney disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int 2019; 95(6):1304–17.
- O'Mara NB. Anemia in Patients With Chronic Kidney Disease. Diabetes Spectrum 2008; 21(1):12–9.
- Kovesdy CP et al. Serum potassium and adverse outcomes across the range of kidney function: A CKD Prognosis Consortium meta-analysis. Eur Heart J 2018; 39(17):1535–42.
- Hoppe LK et al. Association of Abnormal Serum Potassium Levels with Arrhythmias and Cardiovascular Mortality: A Systematic Review and Meta-Analysis of Observational Studies. Cardiovasc Drugs Ther 2018; 32(2):197–212.
- Fishbane S, Spinowitz B. Update on Anemia in ESRD and Earlier Stages of CKD: Core Curriculum 2018. Am J Kidney Dis 2018; 71(3):423–35.
- National Kidney Foundation. Managing Anemia: When You Have Kidney Disease or Kidney Failure. New York; 2014 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/sites/default/files/11-10-6553_managinganemia.pdf.
- Babitt JL, Lin HY. Mechanisms of Anemia in CKD. Journal of the American Society of Nephrology 2012; 23(10):1631–4.
- Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS ONE 2014; 9(1):e84943.
- National Kidney Foundation. Anemia and Chronic Kidney Disease; 2015 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/atoz/content/what_anemia_ckd.
- National Kidney Foundation. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease. Am J Kidney Dis 2006; 47(Suppl 3):S1-S146.
- National Kidney Foundation. What is Hyperkalemia?; 08 Feb 2016 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/atoz/content/what-hyperkalemia.
- National Kidney Foundation. Facts About High Potassium in Patients with Kidney Disease [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/atoz/content/hyperkalemia/facts.
- Dunn JD et al. The Burden of Hyperkalemia in Patients With Cardiovascular and Renal Disease. The American Journal of Managed Care 2015; 21(15):S307-15.
- Einhorn LM et al. The Frequency of Hyperkalemia and Its Significance in Chronic Kidney Disease. Arch Intern Med 2009; 169(12):1156-1162.
- National Kidney Foundation. Potassium and Your CKD Diet; 15 Jun 2020 [cited 16 Oct 2020]. Available from: URL: https://www.kidney.org/atoz/content/potassium.
- National Health Service. Chronic kidney disease; 29 Aug 2019 [cited 20 Oct 2020]. Available from: URL: https://www.nhs.uk/conditions/kidney-disease/.
- Bello AK et al. Complications of chronic kidney disease: Current state, knowledge gaps, and strategy for action. Kidney Int Suppl (2011) 2017; 7(2):122–9.
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplement 2013; (3):1–150.
- Bello AK et al. Global Kidney Health Atlas: A report by the International Society of Nephrology on the current state of organization and structures for kidney care across the globe. Brussels, Belgium: International Society of Nephrology; 2017. Available from: URL: www.theisn.org/global-atlas.
- Thompson S et al. Cause of Death in Patients with Reduced Kidney Function. J Am Soc Nephrol 2015; 26(10):2504–11.
- McCafferty K et al. HEROIC: A 5-year observational cohort study aimed at identifying novel factors that drive diabetic kidney disease: rationale and study protocol. BMJ Open 2020; 10(9):e033923.
- U.S. National Institutes of Health. A Study on Patients With Chronic Kidney Disease (CKD) to Assess Treatment Experience and Patterns, Effect of the Treatment, Patient Outcomes and Patient Quality of Life (DISCOVER CKD) [Identifier: NCT04034992] [cited 02 Oct 2020]. Available from: URL: https://clinicaltrials.gov/ct2/show/NCT04034992.
Veeva ID: Z4-30952
Date of Prep: February 2021