ArticleClinicoEconomics and outcomes research : CEOR2024
Clinical and Economic Impact of Early Diagnosis of Chronic Kidney Disease in General Practice: The Endorse Study.
Article in ClinicoEconomics and outcomes research : CEOR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Projecting the Long-Term Cost-Effectiveness of Once-Weekly Insulin Icodec Versus Once-Daily Basal Insulin Analogs in Italy Using the Prime T2D Model.Diabetes, obesity & metabolism · 2026Article
- Asymptomatic kidney changes discovered during occupational health screening: age-dependent trends from a large cohort.Clinical kidney journal · 2026Article
- Low protein diet with personalized support in advanced chronic kidney disease: association with disease progression, dialysis delay and mortality.Clinical kidney journal · 2026Article
- SGLT2 inhibitor role in cardio-metabolic-renal diseases: a narrative review of recent evidence and their pharmacological, clinical and economic implications.Drugs in context · 2026Review
- Optimizing urine albumin-to-creatinine ratio testing and referral pathways for chronic kidney disease: a nominal group technique consensus study among Italian experts.Journal of nephrology · 2025Article
- "Kidney international reports · 2025Article
- Guideline-Recommended Disease-Modifying Therapies for Patients with Cardiorenal Disease: A Call-to-Action Narrative Review.Advances in therapy · 2025Review
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Authors and funding
18 authors.
Funding
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Abstract
Introduction: The underdiagnosis of chronic kidney disease (CKD) remains a significant public health concern. The Early chroNic kiDney disease pOint of caRe Screening (ENDORSE) project aimed to evaluate the clinical and economic implications of a targeted training intervention for general practitioners (GPs) to enhance CKD awareness and early diagnosis. Methods: Data on estimated Glomerular Filtration Rate (eGFR) and Urinary Albumin-Creatinine Ratio (uACR) were collected by 53 Italian GPs from 112,178 patients at baseline and after six months. The intervention involved six months of hybrid training provided by 11 nephrologists, which included formal lectures, instant messaging support, and joint visits for complex cases. Results: The results demonstrated a substantial increase in the use of eGFR (+44.7%) and uACR (+95.2%) tests. This led to a 128.9% rise in the number of individuals screened for CKD using the KDIGO classification, resulting in a 62% increase in CKD diagnoses. The intervention's impact was particularly notable in high-risk groups, including patients with type 2 diabetes, hypertension, and heart failure. Discussion: A budget impact analysis projected cumulative five-year savings of €1.7 million for the study cohort. When these findings were extrapolated to the entire Italian CKD population, potential savings were estimated at €106.6 million, highlighting significant cost savings for the national health service. The clinical simulation assumed that early diagnosed CKD patients would be treated according to current indications for dapagliflozin, which slows disease progression. Conclusion: The ENDORSE model demonstrated that targeted training for GPs can significantly improve early CKD detection, leading to better patient outcomes and considerable economic benefits. This approach shows promise for broader implementation to address the underdiagnosis of CKD on a national and potentially international scale.
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