Holistic Impact of CKD: A Clinical, Economic, and Environmental Analysis by IMPACT CKD

Chronic kidney disease (CKD) is a growing global health problem driven by aging and the rise of comorbidities, including diabetes and hypertension. Although clinical and economic burdens have been reported, there is a lack of information on the multidimensional impact of CKD across countries with varying demographics and health system archetypes. The validated IMPACT CKD model was used to project the clinical, health care resource use (HCRU), economic, patient, societal, and environmental burden of CKD in 8 countries (Australia, Brazil, China, Germany, Netherlands, Spain, United Kingdom, and United States) over 10 years (baseline: 2022; simulated years: 2023-2032). By 2032, 11.7% to 16.5% of the countries' populations were projected to have CKD, with prevalence rising in 7 countries over 10 years, and a shift toward later stages. These increases were accompanied by projected increases of 3.6% to 170.8% and 41.9% to 80.1% in the number of patients living on dialysis and with a functioning kidney transplant, respectively. Driven by this growing clinical burden, increases of over 19% in CKD costs and 20% in kidney replacement therapy (KRT) costs were projected across all countries. Impaired work productivity led to significant projected losses in gross domestic product, full-time equivalents, and tax revenue. Freshwater consumption, fossil fuel depletion, and carbon production in patients on KRT were projected to increase by over 11% in all the countries. This study demonstrates the multifaceted burden of CKD globally and supports the adoption of policies such as CKD screening programs and public health awareness to promote early diagnosis and treatment to mitigate the growing disease burden.