WCN26-3272 Effect of urinary sodium-to-potassium ratio (U-Na/K) on renal prognosis and life prognosis in outpatients of chronic kidney disease

Methods: Utilizing data from Premier Integrated Labs Sdn Bhd, a private laboratory network with more than 23 laboratories in Malaysia, this retrospective observational study examined CKD prevalence and patterns in urine albumin testing.We analyzed 196,467 eGFR (estimated glomerular filtration rate) records for adults ($18 years) collected between August and September 2025.Data included demographic details (age, gender) and clinical parameters (ACR levels, KFRE scores).Results: Analysis of 196,467 (52% female, 48% male) eGFR records revealed that 9.5% (n=18,617) had CKD Stages 3 to 5, a prevalence lower than previously reported.The identified CKD group showed male predominance (55%) at median of 67 years old.Male patients consistently showed higher representation in all advanced CKD stages (Stages 3a-5) with male-to-female ratios ranging from 1.42 to 1.10.The prevalence of CKD stage 4-5 increased sharply after age 60, peaking at 66-75 years.8,498 patients (4.3% of cohort) had late-stage CKD (Stages 4-5), with Stage 5 alone comprising 34% of all CKD cases, indicating substantial need for renal replacement therapy.A bimodal distribution of CKD was observed.While the precise etiology of this pattern remains uncertain, it may reflect poorly managed disease, accelerated progression, or significant diagnostic delays.Analysis of 21622 ACR data revealed a strong correlation between CKD progression and albuminuria severity.While most of healthy subjects with CKD Stages1-2 had normal urine albumin levels (89.5% in Stage 1, 77.1% in Stage 2).Severely elevated albuminuria (>30 mg/ mmol) increased dramatically in advanced stages: from 19.3% (Stage 3a) to 71.3% (Stage 5).Alarmingly, a significant portion of patients with CKD 1-2 showed clear signs of kidney damage: 10.5% of Stage 1 and 22.9% of Stage 2 patients already presented with elevated albuminuria.Despite the KFRE's effectiveness, it was severely under-utilized, with only 8% (n=1,486) of patients having this calculated score.When applied, the 5-year score successfully identified the highest-risk patients, while the 2-year score provided additional stratification.The fact that 55% of 5-year high-risk patients were also high-risk by the 2year score confirms a consistent high-risk group and validates this tiered approach for guiding more aggressive treatments.Conclusion: Screening penetration for ACR and KFRE in Malaysia remains low, as evidenced by poor CKD awareness.CKD in Malaysia disproportionately affects males and adults over 60, underscoring the need for targeted screening.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.