{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Cardiology, Guangdong provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, The Affiliated Guangdong Provincial People’s Hospital of South China University of Technology, Guangzhou, Guangdong, China"
      ],
      "name": "Yong Liu"
    },
    {
      "affiliations": [
        "Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China"
      ],
      "name": "Chao Zhou"
    },
    {
      "affiliations": [
        "Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, China"
      ],
      "name": "Yibo He"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Yihang Ling"
    },
    {
      "affiliations": [
        "Department of Cardiology, People’s Hospital of Yangjiang, Yangjiang, Guangdong, China"
      ],
      "name": "Xiaoyu Huang"
    },
    {
      "affiliations": [
        "Wuhan Asia Heart Hospital, Wuhan, Hubei, China"
      ],
      "name": "Hua Yan"
    },
    {
      "affiliations": [
        "Department of Cardiology, Longyan First Hospital Affiliated with Fujian Medical University, Longyan, Fujian, China"
      ],
      "name": "Liling Chen"
    },
    {
      "affiliations": [
        "Department of Cardiology, The Fifth Affiliated Hospital of Southern Medical, Guangzhou, Guangdong, China"
      ],
      "name": "Qi Zhou"
    },
    {
      "affiliations": [
        "Department of Cardiology, Gaozhou People’s Hospital, Gaozhou, Guangdong, China"
      ],
      "name": "Xiulong Zhu"
    },
    {
      "affiliations": [
        "Dongguan People’s Hospital, Dongguan, Guangdong, China"
      ],
      "name": "Jianfeng Ye"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zhuhai City People’s Hospital, Zhuhai, Guangdong, China"
      ],
      "name": "Xiaofei Jiang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Linyi People’s Hospital, Linyi, Shandong, China"
      ],
      "name": "Zhihong Ou"
    },
    {
      "affiliations": [
        "Department of Cardiology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China"
      ],
      "name": "Jinying Zhang"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China"
      ],
      "name": "Peng Dong"
    },
    {
      "affiliations": [
        "Department of Cardiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Yi Yan"
    },
    {
      "affiliations": [
        "Daqing People’s Hospital, Daqing, Heilongjiang, China"
      ],
      "name": "Shu Zhang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Wuhan No, Wuhan, Hubei, China"
      ],
      "name": "Liqun He"
    },
    {
      "affiliations": [
        "Cardiology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Biao Xu"
    },
    {
      "affiliations": [
        "School of Medicine, South China University of Technology, Guangzhou, Guangdong, China"
      ],
      "name": "Tian Chang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Xianlin Ruan"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Ling Jing"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Xiaozhao Lu"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China",
        "Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangzhou, Guangdong, China"
      ],
      "name": "Jingru Deng"
    },
    {
      "affiliations": [
        "Department of Cardiology, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China",
        "Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China"
      ],
      "name": "Shiqun Chen"
    },
    {
      "affiliations": [
        "Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China"
      ],
      "name": "Junjie Wang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Southern Medical University, Guangzhou, Guangdong, China",
        "Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangzhou, Guangdong, China"
      ],
      "name": "Jiyan Chen"
    }
  ],
  "title": "Underdiagnosis, treatment pattern and awareness of chronic kidney disease in cardiovascular disease population: results from a national observational study in China",
  "uid": "6fa269b1-6f4d-5599-b54f-d8e36cdd5d1b"
}