OBJECTIVES: The use of RAASis in individuals with chronic kidney disease (CKD) has been associated with improved health outcomes, including delayed estimated glomerular filtration rate decline and lowered risk of cardiovascular complications. However, limited data exist describing the impact of RAASi use on productivity and activity of individuals living with CKD. In this study, we compared the work productivity and activity levels of patients in the DISCOVER CKD cohort with or without RAASi use at baseline.

METHODS: DISCOVER CKD (NCT04034992) is a noninterventional cohort study characterising contemporary real-world management of CKD to provide insights into the current gaps in CKD treatment. The study includes both retrospective and prospective cohorts, integrating primary and secondary data collection. The prospective phase recruited patients from Sweden, USA, UK, Italy, Japan and Spain. The impact of disease on paid and unpaid work and daily activities of life was assessed using the Work Productivity and Activity Impairment CKD (WPAI-CKD) questionnaire, which employed a 7-day recall period. Domain scores were compared between individuals with and without RAASi treatment at baseline using an analysis of covariance model with adjustment for age, sex, country, CKD stage, comorbidity and number of other medications. P<0.05 was considered statistically significant. The study received ethics approval and all patients provided informed consent.

RESULTS: In total, 236 RAASi users and 182 non-RAASi users completed the WPAI-CKD questionnaire. The results indicated that individuals receiving RAASi therapy experienced lower percentages of missed work time (difference: –5.5; P=0.017), work impairment (difference: –7.5; P=0.025), activity impairment (difference: –8.9; P<0.001) and overall work productivity loss (difference: –10.3; P=0.009) compared with patients not using RAASis.

CONCLUSIONS: These results show an association between RAASi use and increased work productivity and activity levels in individuals with CKD, suggesting that working capability can be further improved through enhanced CKD management.