Abstract
Chronic kidney disease (CKD) is not recognized until it is too late for preparation for kidney replacement therapy (KRT). Using published nationwide registry data and available literature, this secondary analysis aimed to quantify the late-diagnosis gap in Kazakhstan, and to compare results with international evidence and KDIGO 2024 guidelines. Of 9,097 patients who started KRT, 74% were diagnosed within six months prior to their therapy. There was an 11 percentage-point increase in crude proportion of deaths, and a decrease in transplantation, with a 1.18 increase in adjusted mortality hazard, for late diagnosis. The results were useful for proposing risk-based referral, laboratory follow-up and measurement of the effectiveness of the screening process for CKD in Kazakhstan.