TILDA Report Launched on Chronic Kidney Disease in Community Dwelling Adults
Researchers at TILDA, Trinity College Dublin have conducted a study in conjunction with the HSE to discover how many people in Ireland aged 50 years and older are affected by chronic kidney disease (CKD). This was the largest study performed in Ireland to date on this important public health problem and analysed data from the Irish Longitudinal Study on Ageing (TILDA) to describe chronic kidney disease (CKD) in Ireland. The presence of CKD identifies individuals who are at increased risk of adverse health outcomes, including cardiovascular disease, premature death, and potentially progression to requiring dialysis or a kidney transplant. As such, preventing and managing CKD constitutes a key public health priority. CKD was present in 15.6% of people aged 50+ in Ireland, which equates to approximately 226,000 people or 1 in 7 of the population. Surprisingly 98% of people who had CKD were unaware they suffered from it. Whereas blood pressure management should be tightly controlled in CKD to prevent or slow down progression, blood pressure was poorly controlled in CKD in Ireland.
We found that CKD is becoming more common over time in Ireland, consistent with Ireland’s rapid demographic changes, highlighting the importance of action in primary and secondary care to raise awareness and to improve the outcomes for people living with CKD in Ireland. New cases of CKD in Ireland in people aged 50 years and over are occurring at a rate of 16 people per 1000 person-years of follow up which will likely also contribute to substantial future demand on Nephrology services and hospital inpatient stay now and in future.
There are also now new treatments proven in trials to alter the course of CKD thereby reducing progression to established kidney disease.
Lead author Prof Donal Sexton of TILDA and Consultant Nephrologist at St James’s Hospital said “This report arose out of collaboration between TILDA and Professor Mellotte at the National Renal Office of the HSE. It is extremely important for people with chronic kidney disease since it highlights how common chronic kidney disease is in people in Ireland aged 50 years and over and emphasises the need for increased awareness and treatment of the condition. The incorporation of chronic kidney disease into the chronic disease management program in Ireland may facilitate improved treatment of the condition in primary care.”
Professor Kenny, PI of TILDA said “Ireland is the fastest ageing country in Europe. In Ireland, we spend one fifth of our lives with disability and significant disease. CKD is an important and hitherto neglected cause of such disability in ageing. The aim of this TILDA research is to characterise CKD in adults in Ireland and raise awareness of how common it is(1 in 7 adults over 50y) and how, if it is identified sufficiently early, we can manage its course and lessen its more severe health consequences. The data will assist new screening, referral and management pathways for CKD and increase independent living and quality of life for Irish adults".
Prof George Mellotte, National Clinical Director for Renal Services commented: “The National Renal office (NRO) proposes to use the clinical epidemiology data from this report to help inform the design of the model of care and service development for early Chronic Kidney Disease in the community and to advocate for CKD to be included as part of the National Chronic Disease Management Program.”
Prof Colm Henry, Chief Clinical Officer in the Health Service Executive, commented: “CKD is one of the most common comorbidities amongst the conditions already covered by the Chronic Disease Management Program. In the advent of new disease modifying medications, screening for CKD in high risk groups is of paramount importance, in particular in primary care and opportunistic screening in secondary care. This work will help inform not just our renal service, but also chronic disease and renal transplant programmes’.
Carol Moore, CEO of the Irish Kidney Association commented: “The Irish Kidney Association congratulates the National Renal Office and TILDA for their impactful study on Chronic Kidney Disease (CKD) in Ireland's older population. The high prevalence of CKD in those who are 50 years and older and extremely low awareness among those affected highlights the need for more education around CKD and that it should not be viewed in isolation but rather as an integral part of other health conditions such as diabetes, high blood pressure, and cardiovascular disease. A holistic and collaborative approach will ensure better health outcomes and reduced healthcare costs. The results of the survey reinforce the Irish Kidney Association calls for CKD to be integrated into the HSE National Chronic Disease Management Programme as a crucial step forward.”
Read the report here.