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Background Chronic kidney disease (CKD) represents one of the most significant risk factors for adverse cardiovascular events and mortality. Data on real-world clinical practice of Chinese patients with CKD in the cardiology department is limited. Objectives This study aims to investigate the proportion of underdiagnosis, guideline-directed therapy and awareness of CKD among Chinese patients. Methods It was a multicentre observational study conducted in 25 tertiary hospitals across China. Patients with two consecutive measurements (separated by 90–730 days) of either: (1) estimated glomerular filtration rate 20–60 mL/min/1.73 m², or (2) urinary albumin-to-creatinine ratio (UACR) ≥30 mg/g, with documented cardiology hospitalisation from 2022 to 2024 were eligible. Participants completed a lifestyle and awareness questionnaire after inclusion. The proportion of underdiagnosis, guideline-directed therapy and awareness of CKD was calculated. Results Among 2099 participants (median age 74.0 years; 64.6% male), 76.7% were underdiagnosed with CKD (lacked a CKD diagnostic code at discharge). Only 16.7% of participants underwent UACR testing and all individuals with isolated albuminuria (UACR >30 mg/g) remained underdiagnosed. Underdiagnosis was more common in patients aged 60–75, those with early-stage CKD, hospital stays <6 days or without comorbidities. The proportion of guideline-directed treatment was suboptimal: sodium-glucose cotransporter-2 inhibitors (36.5%), renin-angiotensin system inhibitors (56.5%) and only 32.2% of patients received guideline-directed treatment. CKD awareness lagged behind hypertension and diabetes, with <25% achieving guideline-recommended blood pressure and glycaemic targets. Conclusions Alarmingly high proportion of underdiagnosed CKD, suboptimal guideline-directed treatment, and poor disease awareness of CKD in cardiology practice require urgent action. Closing these gaps is needed to reduce preventable cardiovascular morbidity and mortality.
Liu et al. (2026) studied this question.