Comparison of risks and costs of undiagnosed and diagnosed chronic kidney disease patients after the…

Cohort studyFrontiers in medicine· 2026

Comparison of risks and costs of undiagnosed and diagnosed chronic kidney disease patients after the initiation of kidney replacement therapy in subsequent years. A Hungarian nationwide study.

Levente Kovács, Zsolt Abonyi-Tóth, György Rokszin … Boglárka Laczy

NephrologyCohort studyPrognosisQ1IF 3.4

Undiagnosed chronic kidney disease patients faced far higher death risk after starting dialysis

Comparison of risks and costs of undiagnosed and diagnosed chronic kidney disease patients after the initiation of kidney replacement therapy in subsequent years. A Hungarian nationwide study.

Levente Kovács … Boglárka Laczy

Frontiers in medicine · 2026 · Q1 in General Medicine

Background

Despite high prevalence, chronic kidney disease (chronic kidney disease) often remains undiagnosed and untreated, leading to an increased risk of end-stage kidney disease (end-stage kidney disease), kidney replacement therapy (kidney replacement therapy), comorbidities, and premature death.

Methods

We compared the risk of primary endpoints after kidney replacement therapy initiation (including all-cause mortality, acute myocardial infarction, stroke, hospitalization for heart failure (hospitalization for heart failure), lower limb amputation (lower limb amputation), cancer, kidney transplantation) using propensity score subclassification for 56 confounders (matched data).

n = 38,013 ESKD patients

Results

undiagnosed patients died at over 3 times the rate of diagnosed patients

HR 3.66 (95% CI 3.12 to 4.29)

null 1

3.12

4.29

CI excludes the null - significant

More results

We identified 38,013 end-stage kidney disease patients on kidney replacement therapy in 2009-2023, of whom 10,810 started dialysis in 2014-2018.

Among these, 33% were undiagnosed (chronic kidney disease naive).

More results

Median survival was markedly shorter for chronic kidney disease naive patients (3 months) than for chronic kidney disease non-naive patients (34 months).

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Conclusion

These findings underscore the need for early chronic kidney disease diagnosis and timely interventions to improve survival and optimize healthcare resource utilization.

Comparison of risks and costs of undiagnosed and diagnosed chronic kidney disease patients after the initiation of kidney replacement therapy in subsequent years. A Hungarian nationwide study.

Comparison of risks and costs of undiagnosed and diagnosed chronic kidney disease patients after the initiation of kidney replacement therapy in subsequent years. A Hungarian nationwide study.

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