CHRONIC KIDNEY DISEASE SCREENING AMONG PATIENTS TREATED FOR TYPE 2 DIABETES AND/OR HYPERTENSION IN GREECE: NATIONWIDE REAL-WORLD EVIDENCE FROM THE ELECTRONIC PRESCRIPTION SYSTEM
Author(s)
Georgia Kourlaba, PhD1, Garyfallia Stefanou, MSc1, Konstantinos Mathioudakis, MSc2, Anastasios Tsolakidis, PhD2, Dimitrios Zografopoulos, PhD3, Stavros Liatis, PhD4.
1Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece, 2IDIKA SA - e-Government Center for Social Security Service, Athens, Greece, 3Greek Ministry of Health, Athens, Greece, 4First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece.
1Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece, 2IDIKA SA - e-Government Center for Social Security Service, Athens, Greece, 3Greek Ministry of Health, Athens, Greece, 4First Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece.
OBJECTIVES: Chronic kidney disease (CKD) is a frequent complication of type 2 diabetes mellitus (T2DM) and hypertension. However, real-world evidence on CKD screening in high-risk populations remains limited. This study estimated CKD screening uptake among adults treated pharmacologically for T2DM and/or hypertension in Greece, during follow-up and annually.
METHODS: We conducted a nationwide retrospective cohort study using the Greek electronic prescription and referral system. Adults with ≥2 executed prescriptions carrying ICD-10 codes E11* and/or I10* between January 1, 2021 and December 31, 2025 were included if their index date, defined as the first eligible prescription, occurred during 2021-2024. Patients with CKD-related treatment, defined as N18* prescriptions, before index or within three months post-index were excluded. Follow-up extended from index until death or December 31, 2025. CKD screening was defined as referral for serum creatinine, used as an eGFR proxy, and/or urine albumin-to-creatinine ratio (uACR/ACR). We estimated uptake during follow-up and annual screening consistency, defined as screening in every complete follow-up year.
RESULTS: The study included 2,822,425 treated patients: 353,270 with T2DM only, 1,597,043 with hypertension only, and 872,112 with both conditions. Overall, 90.4% had ≥1 CKD screening assessment during follow-up, almost entirely driven by eGFR-related testing (90.4%). Only 6.0% underwent uACR/ACR testing, with a nearly identical proportion having both assessments. CKD screening uptake was highest among patients with both T2DM and hypertension (94.0%) versus T2DM only (88.9%) and hypertension only (88.7%). Annual screening consistency was 46.4%, largely reflecting eGFR-related testing, whereas consistency for uACR/ACR and complete screening was only 0.4%.
CONCLUSIONS: Serum creatinine/eGFR-related testing appears embedded in routine care in Greece, but annual CKD screening is inconsistent and albuminuria testing is markedly underused, despite its role in detecting early kidney damage even when eGFR is preserved. Health-system strategies are needed to improve guideline-concordant CKD screening, particularly uACR/ACR testing.
METHODS: We conducted a nationwide retrospective cohort study using the Greek electronic prescription and referral system. Adults with ≥2 executed prescriptions carrying ICD-10 codes E11* and/or I10* between January 1, 2021 and December 31, 2025 were included if their index date, defined as the first eligible prescription, occurred during 2021-2024. Patients with CKD-related treatment, defined as N18* prescriptions, before index or within three months post-index were excluded. Follow-up extended from index until death or December 31, 2025. CKD screening was defined as referral for serum creatinine, used as an eGFR proxy, and/or urine albumin-to-creatinine ratio (uACR/ACR). We estimated uptake during follow-up and annual screening consistency, defined as screening in every complete follow-up year.
RESULTS: The study included 2,822,425 treated patients: 353,270 with T2DM only, 1,597,043 with hypertension only, and 872,112 with both conditions. Overall, 90.4% had ≥1 CKD screening assessment during follow-up, almost entirely driven by eGFR-related testing (90.4%). Only 6.0% underwent uACR/ACR testing, with a nearly identical proportion having both assessments. CKD screening uptake was highest among patients with both T2DM and hypertension (94.0%) versus T2DM only (88.9%) and hypertension only (88.7%). Annual screening consistency was 46.4%, largely reflecting eGFR-related testing, whereas consistency for uACR/ACR and complete screening was only 0.4%.
CONCLUSIONS: Serum creatinine/eGFR-related testing appears embedded in routine care in Greece, but annual CKD screening is inconsistent and albuminuria testing is markedly underused, despite its role in detecting early kidney damage even when eGFR is preserved. Health-system strategies are needed to improve guideline-concordant CKD screening, particularly uACR/ACR testing.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD35
Topic
Epidemiology & Public Health, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Urinary/Kidney Disorders