OBJECTIVES: Chronic kidney disease (CKD) is ~ 10% prevalent worldwide whereas ~ 12% in Belgium, with numerous patients unaware of their condition. The cost of end-stage renal disease is known to be very high. However, the burden of earlier CKD stages is less well studied despite being crucial for public health and policy planning. Inside CKD aims to estimate the CKD burden in Belgium from 2022 to 2027, using patient-level microsimulation modelling.

METHODS: The microsimulation constructs a virtual population from available Belgium-specific data on demographics; CKD status; comorbidities; all-cause mortality (ACM); and associated costs. The projections from baseline to 2027 are under the assumption that no additional healthcare/policy interventions occur in the meantime. The model methodology and validation have been published earlier.

RESULTS: Without healthcare/policy intervention, the Belgian prevalence of CKD will remain high at 14% in 2027. Renal replacement therapy (RRT) cases are projected to 17,881, representing an overall growth of 12% versus 2022. Cardiovascular complications also remain high. The diagnosis rates for stages 3a and 3b remain low at 37 and 40%, respectively. Out of 231,954 cumulative all-cause deaths in the diagnosed CKD population between 2022 and 2027, ~30% are accounted to stages 3a and 3b. Out of €2.15 billion annual healthcare costs projected for CKD, the highest cost (€0.97 billion) was related stages 3a-3b, followed by that of RRT (€0.8 billion), highlighting the need for preventing future burden but also interventions at the mid-stages.

CONCLUSIONS: Inside CKD demonstrates that, without additional healthcare/policy interventions, the burden of CKD in Belgium will remain high in the coming years. Not only the severe stages requiring RRT but also the earlier stages impose a huge burden on the Belgian healthcare system. National and regional policies aimed at earlier diagnosis and intervention are therefore necessary.