Seeing a new perspective in anaemia in chronic kidney disease

WRITTEN BY

Dr Ian Sabir, Head of Medical Affairs, Cardio-Renal, AstraZeneca

We are committed to improving the lives of people with chronic kidney disease (CKD). Our mission is to explore disease progression as well as serious complications caused by CKD. As kidney function declines, anaemia is a common complication that arises. Anaemia in CKD is a potentially serious condition characterised by decreased haemoglobin levels, and is associated with an increased risk of cardiovascular disease, hospitalisation and mortality if not effectively managed.[1] Common symptoms of anaemia in CKD include fatigue, weakness and paleness.[2]

As this condition is a new area for AstraZeneca to understand and explore, last year we commissioned a survey of CKD patients, where we sought to develop a better understanding of their awareness and knowledge of anaemia in CKD. The results of the survey highlighted the burden of this condition and have helped us to better appreciate the challenges faced by our patients.

Patient perceptions of their care are invaluable but only tell part of the story – we also needed to explore the perceptions of the clinicians who manage and treat CKD patients with anaemia, and the relationship they have with their patients. With that in mind, this year we surveyed 426 nephrologists across seven countries – Australia, Brazil, Canada, China, India, Mexico and the US – with the aim of building a more comprehensive picture of those involved in the treatment pathway and to better understand the barriers they are facing.[3]

Management of anaemia in CKD

Comparing the findings from the nephrologist survey with those from the patient survey reveals both notable commonalities and discrepancies in the management and perceptions of anaemia in CKD. Nearly all nephrologists agree (88%) that anaemia in CKD impacts patients’ quality of life.3 Further, most nephrologists recognise that anaemia in CKD is associated with an average of 86% increase in combined morbidity and mortality in both dialysis and non-dialysis patients.[3]

Despite this, 44% of nephrologists felt that anaemia in CKD receives too little time and attention in dialysis and non-dialysis patients. [3]

What I find encouraging is that nephrologists recognise not only the serious consequences of anaemia in CKD, but how it impacts patients day-to-day. Our nephrologist survey revealed that an average of 80% of patients will proactively report a lack of energy – a well-documented symptom of anemia in CKD – during an office visit.[2,3]This is consistent with what we found in our patient survey, which sampled 500 CKD patients in the US and 500 CKD patients in China in 2018.[4] This survey found that 84% of CKD patients in the US and 64% in China said they have a lack of energy as a result of their anaemia. [4]

These perspectives, and other results from the two surveys collectively, have served as an important foundation to improve our understanding of anaemia in CKD. We will work collaboratively with patients and HCPs to understand the tools they need to feel more confident about effective management of anaemia in CKD.

Collaborating to support each other

Last month I attended the International Society of Nephrology, World Congress of Nephrology in Melbourne, Australia. While in Australia, we hosted a Health Alliance Policy Roundtable and we brought together nephrologists from across Argentina, Australia, China, Hong Kong and Mexico for a first-of-its-kind meeting in this region. The aim of the Roundtable was to discuss the findings of our survey with experts in the field, in order to identify how we as a community can better support those impacted by anaemia in CKD. Meeting participants confirmed the findings from their peers who participated in the survey.

Having discussions like these about common CKD complications such as anaemia, helps us better understand nephrologists’ priorities when managing complex patients with underlying co-morbidities and new complications.

I am encouraged by the enthusiasm among the experts who attended the Roundtable and share their optimism that if we work together to engage with patients and clinicians, we can improve care and treatment for CKD patients and ultimately support improved patient outcomes.

References

[1] Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO clinical practice guideline for anemia inchronic kidney disease. Kidney Int Suppl. 2012 Aug;2(4): 279-335.

[2] National Institute of Diabetes and Digestive and Kidney Diseases. “Anemia in Chronic Kidney Disease.” 2014. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/anemia. Last Accessed April 2019.

[3] Investigating Clinical Practice of Chronic Kidney Disease Related Anemia 2019 - Data on File. REF-53075

[4] AstraZeneca. 2018. Data on File. REF-47254.

 

Veeva ID: Z4-16941
Date of prep:15/05/2019
Date of expiry:15/05/2021