Chronic kidney disease screening in primary care: a descriptive analysis of the Girona Sud health region

Abstract

Aims: Chronic kidney disease (CKD) is a major global health concern, often underdiagnosed in primary care settings. This study aimed to assess CKD screening practices using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) among individuals in a primary care population in Girona Sud, Catalonia. Methods: A cross-sectional analysis was conducted using anonymised electronic health records from Girona Sud primary care centres. We included active patients aged ≥ 15 years with a recorded medical history. Demographic, clinical, and laboratory data, including eGFR and UACR, were analysed. CKD was defined as eGFR < 60 ml/min/1.73 m² and/or UACR ≥ 30 mg/g. Descriptive and inferential statistical analyses were performed. Results: Among the studied population (N = 230,922), 37% had mildly decreased eGFR (60–89 ml/min/1.73 m²), while 3% had more advanced CKD (G3b-G5). Albuminuria was mostly A1 (89%), with moderate (9.4%) and severe (1.8%) cases observed. Screening was more frequent in patients with type 2 diabetes, hypertension, and dyslipidaemia. Renal protective drugs, such as ACE inhibitors, ARBs, and SGLT2 inhibitors, were mainly prescribed in early CKD stages. Conclusions: Early-stage CKD is prevalent in our primary care population, particularly among those with cardiometabolic conditions. It is important to optimize the CKD detection and management in primary care. Despite the availability of renal protective treatments, their underutilization in advanced stages of CKD highlights missed opportunities for timely and optimal intervention.