A new study by researchers at the University of Limerick revealed the extremely high burden of kidney disease in older people in Ireland who suffer from common chronic diseases.
Researchers also found that economic and social factors are affecting them – medical cardholders and unemployed people are much more likely to develop kidney disease.
Women were 50% more likely to have chronic kidney disease than men, according to a new study by researchers at the University of Limerick School of Medicine. European Kidney Association's Clinical Kidney Journal.
The publication of the study coincides with World Kidney Day on Thursday, March 13th, whose main focus is early detection of kidney disease to protect long-term kidney health.
The findings provide new hope for thousands of patients living with kidney disease in Ireland and help implement a national screening program targeting high-risk groups to reduce the lifetime risk of renal failure and dialysis.
This study also occurs when several new treatments have been shown to slow the progression of kidney disease.
Ireland has an estimated 500,000 individuals suffering from chronic kidney disease. Many pose a serious risk of progression to kidney failure and early death. Over 5,400 of these individuals have already developed kidney failure and are being treated either with dialysis or a kidney transplant.
The goal of this study was to estimate the prevalence of chronic kidney disease in a representative sample of the Irish population age 50 and above, and to determine which groups had the highest disease burden so that this information could be used to target these groups as part of the national population health screening programme.
In the largest study of this species in Ireland, this study used data from the Irish Longitudinal Study of Aging (TILDA) to investigate detailed factors associated with kidney disease.
One in seven people found to be chronic kidney disease in Ireland (14.7%), up from 50 years of age and over, which increased to one in two people over 75 years of age. Women were more affected than men (17.8% vs. 11.5%). This is a finding that has persisted across all age groups.
A detailed analysis revealed that the burden of chronic kidney disease is much more common in individuals with common chronic diseases, including pre-existing heart disease (33.9%), diabetes (28%), cancer (25.5%), and bladder problems (23.7%).
Similarly, chronic kidney disease was affected in 1 in 5 cases with arthritis, hypertension, obesity and chronic lung conditions, and was much more common in patients with chronic lung disease. These are common clinical conditions that are routinely identified and managed in primary care.
The study also found that several socioeconomic indicators have important links to chronic kidney disease and should be considered in a comprehensive population health strategy. One in four people on the medical card had evidence of kidney disease (25.5%), as well as individuals who were frequently admitted.
Among the important findings are
- The prevalence of chronic kidney disease was much more common than the national average in people with heart disease, diabetes, hypertension, and chronic lung conditions.
- Women are more likely to have chronic kidney disease than men
- Cancer, obesity and social deprivation contributed to the burden of kidney disease independent of traditional risk factors
- Obese people were twice as likely to develop kidney disease than their normal weight.
- People with hypertension, diabetes, cardiovascular disease, and cancer were 1.5 times more likely to have kidney disease
- The proportion of patients with renal disease in the population was dependent on the formula used.
The study was led by Dr. Meera Tandan, a postdoctoral researcher at the National Kidney Disease Surveillance System (NKDSS) at the UL School of Medicine.
She explained: “Chronic kidney disease causes major problems in the Irish population and has a major impact on patient survival and quality of life.
“Our study produced an accurate estimate of the burden of kidney disease in Ireland, identifying the highest risk individuals in our community. It has shown that chronic kidney disease is very common among individuals with certain chronic diseases, with the majority of which generally being managed in primary care.
“For the first time, we highlighted the importance of new conditions, such as cancer and obesity, as these conditions have contributed significantly to the high burden of kidney disease in the population,” Dr. Tandan added.
Dr. Leonard Brown, a senior researcher at NKDSS at UL, highlighted the importance of gender and social situations in assessing the risk of chronic kidney disease.
“Women are 50% more likely to have chronic kidney disease than men, and this finding lasted despite knowing risk factors such as age, diabetes, and hypertension. This means that women are at a higher risk of kidney disease than men, which should be considered in the development of national screening strategies.
“We found that key factors of social deprivation, such as unemployment, reduced educational achievement, and dependence on instrumentalized healthcare, are strongly associated with chronic kidney disease.
“Unemployed people have five times the prevalence of kidney disease than their employed counterparts, and those receiving free or subsidized healthcare are 30% more likely to have kidney disease take into account everything else. These findings highlight the impact of social disadvantages on chronic kidney disease.
Professor Austin Stack, a senior author of the study and senior author of NKDSS at Limerick University, UL's medical school and consultant nephrologist, explained:
“It could potentially stop the tide of renal failure and improve patient survival. Early detection of diseases via active or passive surveillance systems is an effective way to prevent chronic diseases, especially when the disease is common and treatable and can be detected by simple screening tests.
“The addition of chronic kidney disease to HSE's chronic disease management program, which will be launched in July 2025, is a major step forward in improving kidney health in Ireland,” added Professor Stack.
Carol Moore, CEO of the Irish Kidney Association, welcomes the findings. “This report is timely in that the current detection and management needs are also recognized at the international level. We are calling on the government to support the resolutions of the World Health Organization.
Professor George Melott, director of the National Renal Cranium and consultant nephrologist, said:
