Publication:

Bridging gaps in chronic kidney disease management: insights from clinicians on real-world practices

Background Chronic kidney disease (CKD) is frequently underdiagnosed in early stages, especially in India, due to its asymptomatic onset, limited diagnostics, and delayed referrals. This study aimed to assess real-world CKD management practices and gaps among Indian clinicians.

Methods A structured survey of 40 clinicians across 11 cities in India captured data on CKD staging, treatment preferences, and complication(s) management.

Results Early-stage CKD (3a/3b) was most commonly diagnosed stage of CKD. Moreover, diabetic nephropathy was prevalent in 55% cases, followed by hypertensive nephropathy in 35% cases and other risk factors in 10% cases. Sodium-glucose cotransporter 2 inhibitors, nonsteroidal mineralocorticoid receptor antagonists (finerenone), and glucagon-like peptide-1 receptor agonists were preferred in diabetic CKD. Metformin was often de-escalated at Stage 3b. For complications, sodium polystyrene sulfonate and darbepoetin alfa were commonly used for hyperkalaemia and anaemia, respectively. Budesonide emerged as a key choice in IgA nephropathy.

Conclusions Despite increasing use of evidence-based therapies, significant gaps remain in early diagnosis and uniform management, highlighting the need for improved awareness and access to newer agents to optimize CKD care.