Reference: July 2025 | Issue 7 | Vol 11 | Page 17
Researchers at the University of Limerick (UL) have revealed an extraordinarily high burden of chronic kidney disease (CKD) among people over 50 that suffer from several common chronic conditions in Ireland. The team of investigators used data from wave 1 of the Irish Longitudinal Study on Ageing to evaluate the burden, prevalence, determinants, and distribution of CKD in Ireland in order to inform strategies for population health planning and support early detection and treatment of CKD.
In one of the largest studies of its kind in the country, the principal findings support the introduction of a national screening programme to target these high-risk groups, help reduce the lifetime risk of kidney failure, and the subsequent requirement for renal replacement therapy. Publication of the research in the Clinical Kidney Journal of the European Renal Association coincided with World Kidney Day, which took place on 13 March, 2025.
High burden of CKD in Ireland
Ireland has a significant ageing population and emerging evidence points to a growing population with advanced kidney disease. An estimated 500,000 people are currently living with CKD across the country, with over 5,400 of these receiving either dialysis or a kidney transplant. Over the last decade, the number of patients requiring renal replacement therapy has risen by 30 per cent and this figure is projected to continue to increase.
Renal disease is associated with substantial morbidity and mortality, particularly in the later stages, and places a large burden on patients and their families. Furthermore, management strategies demand concordance with a challenging regimen of diet and fluid restrictions, medications, and treatments that impact all aspects of the person’s life and its quality.
The overall healthcare system is also heavily affected by CKD. The cost burden of dialysis alone is estimated to be in the region of €300 million annually in Ireland, and providing dialysis treatment for one patient suffering from end-stage kidney disease over a 15-year period costs around €2 million. Early detection and treatment promote optimal patient outcomes; therefore, improved strategies to prevent, detect, and treat CKD in Ireland are greatly needed as incidence of the disease continues to rise.
The goal of the UL study was to estimate the prevalence of CKD in a representative sample of the Irish population aged 50 and over and to identify at-risk groups within this sample population. All participants were aged 50+ years and had both plasma creatinine and cystatin C measured at baseline, both of which are measures of a person’s kidney function. The analysis revealed that one in seven individuals aged 50 and over suffers from CKD (14.7%), rising to one-in-two for those in the over-75 population.
The cross-sectional study was led by Dr Meera Tandan, a postdoctoral researcher at the National Kidney Disease Surveillance System (NKDSS), UL School of Medicine. Commenting on the research, Dr Tandan said: “CKD poses a huge problem for the Irish population and exerts a significant impact on patient survival and quality of life.
“Our research has generated precise estimates of the burden of kidney disease in Ireland and identified those individuals with the greatest risk in our community. We have shown that CKD is very common among individuals with certain chronic conditions, the majority of which are generally managed in primary care. We have also, for the first time, highlighted the importance of new conditions like cancer and obesity, as these conditions contributed greatly to the high burden of kidney disease in the population.”
Key findings
The analysis showed that the prevalence of CKD was highest in people with cardiovascular disease (33.9%) and diabetes (28.0%). Researchers also found high prevalence of disease among those with cancer (25.5%), urinary incontinence (23.7%), bone diseases (21.5%), hypertension (19.8%), and obesity (19.5%).
A detailed multivariable analysis found that people living with specific chronic conditions had higher likelihood (odds ratio OR) of developing CKD – notably hypertension (OR 1.78), diabetes (OR 1.45), cardiovascular disease (OR 1.43), cancer (OR 1.53), overweight (OR 1.37), and obesity (OR 2.33).
“Women were 50 per cent more likely to have CKD than men and this finding persisted despite taking into consideration known risk factors like age, diabetes, and hypertension,” said Dr Leonard Browne, Senior Research Fellow at the NKDSS in UL.
“It draws attention to the fact that women have a greater burden of kidney disease than men and this fact should be considered in the development of any national screening strategy. We also found that key components of social deprivation – including unemployment, lower educational attainment, and reliance on means-tested healthcare – were strongly linked to CKD.
“Unemployed individuals had a five-fold higher prevalence of kidney disease than their employed counterparts and those receiving free or subsidised healthcare were 30 per cent more likely to have kidney disease, taking everything else into consideration. These findings underscore the impact of social disadvantage on CKD. Early detection and management strategies must prioritise at-risk communities to ensure better access to care and support.”
Implications for the future
The study was conducted under the leadership of Prof Austin Stack, Director of the NKDSS and Consultant Nephrologist, University Hospital Limerick. Prof Stack said that the findings “provide an enormous opportunity to the Irish health service to identify and screen these high-risk groups for early signs of kidney damage”.
Speaking to Update Prof Stack said: “Earlier detection of kidney disease will facilitate more timely investigation and treatment, leading to better outcomes. There is a real chance that we can stem the tide of kidney failure and improve patient survival.
“Detecting disease early through an active or passive surveillance system is an effective way of preventing chronic disease, especially if the disease is common, treatable, and can be detected with simple screening tests. CKD ticks all these boxes. The addition of CKD to the Chronic Disease Management Programme of the HSE to begin later in 2025 is a major step forward in improving kidney health in Ireland.”
Reference
Tandan M, Browne LD, Jalali A, Rowan C, Moriarty F, Stack AG. Prevalence and determinants of chronic kidney disease among community-dwelling adults, 50 years and older in Ireland. Clin Kidney J. 2025;18(3):sfaf065.
