Therapeutic Focus

Chronic kidney disease (CKD) is a worldwide public health problem with steadily increasing incidence, prevalence and cost. Key factors driving CKD in developed countries include aging populations and the current epidemic of obesity and its associated complications of hypertension and adult-onset diabetes. Nearly 80% of CKD cases have etiologies linked to hypertension and diabetes. The worldwide incidence of adult-onset diabetes alone is expected to double by 2030 to approximately 366 million.

In North America, there are currently almost 26 million patients with CKD. According to the National Kidney Foundation (NKF), 20 million North American patients suffer from moderate CKD (Stages 3 and 4) to severe CKD (Stage 5). Stages 3 and 4 are characterized by progressively decreasing kidney function as measured by glomerular filtration rate. In Stage 5, kidney function is minimal to altogether absent and patients require regular dialysis or kidney transplant for survival. An estimated 71-97% of CKD patients have vitamin D insufficiency, which can lead to secondary hyperparathyroidism (SHPT) and resultant debilitating diseases including bone disease, markedly increased bone fracture rates, pervasive soft tissue calcification, cardiovascular disease, muscle weakness and reduced quality of life. Recent evidence suggests that some, if not all, of these adverse outcomes can be prevented, mitigated or reversed by early diagnosis and proper treatment.

Prevalence of Stages 3-5 CKD and Related Comorbidities:

Stage
Description
Prevalence
% of CKD Patients with Vitamin D Insufficiency
% of CKD Patients with SHPT
3
Moderate decrease in kidney function
18.7 million
71%
40%
4
Severe decrease in kidney function
1.4 million
83%
82%
5
Kidney failure
0.5 million
97%
95%

*USRDS 2013 ADR
Levin, A et al., Kidney Int 2007;71:.31-38.
Gonzalez, E et al., Am J Nephrol 2004;24:503-510.
LaClair, R et al., Am J Kidney Dis 2005; 45:1026-1033.
Tentori, F et al., Clin J Am Soc Nephrol 2015:10;93-109

 
     
     
 
   

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