Prevalence and Management of Chronic Kidney Disease in Irish Primary Care Network

Background: Chronic kidney disease (CKD) imposes a substantial burden on health systems and society. Although early detection and guideline-recommended management can improve outcomes, opportunities remain to enhance management in primary care. Aim: To evaluate CKD prevalence, guideline-directed medical therapy (GDMT), and monitoring in Irish primary care. Design and Setting: Retrospective cohort study using community-based electronic health records (EHR) from the CRADLE database, across 66 Irish practices. Methods: Active adults aged ≥20 years on 30 July 2025 were included. CKD prevalence was determined using estimated glomerular filtration rate (eGFR) and/or urine albumin-to-creatinine ratio (uACR). Descriptive analyses of epidemiology, prescribing, and monitoring were conducted. Results: Of 468,534 adults, 19,382 met the criteria of laboratory-confirmed CKD: age- and sex-standardised prevalence was 5.36%. 74.0% of laboratory-confirmed CKD patients have ≥1 cardiometabolic comorbidities. Within 12 months of laboratory-confirmed CKD, monitoring increased over time, with 66.0% of patients receiving follow-up eGFR test and 15.1% receiving uACR test, falling to 6.6% among patients without type 2 diabetes (T2DM). Among GDMT-eligible CKD patients, 64.0% received any renin-angiotensin-aldosterone inhibitors (RAASi) and 30.9% received any sodium-glucose cotransporter 2 inhibitors (SGLT2i) after they met their prescription eligibility for CKD, but SGLT2i use dropped to 9.4% among those without T2DM or heart failure. Conclusion: CKD and cardiometabolic comorbidities impose a substantial burden in Irish primary care. Despite improved kidney function testing, albuminuria testing remained low, particularly in non-diabetic patients, and GDMT use was suboptimal. Improving albuminuria testing and timely GDMT offers important opportunities to improve CKD outcomes in Irish primary care.