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This study examined CKD-related laboratory testing and anemia management patterns in Japanese primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Japan Medical Data Survey (JAMDAS) database, we analyzed electronic health records from Japanese primary care clinics. We included patients aged\u2009\u2265\u200918\u00a0years who received antihypertensive or antidiabetic medications at least twice in 2024 and visited clinics quarterly, excluding those who received kidney replacement therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 859,044 eligible patients (mean age: 70.3\u00a0years; men: 48.9%), estimated glomerular filtration rate, dipstick proteinuria, serum potassium, and hemoglobin were measured in 76.2%, 11.2%, 62.9%, and 69.6% of patients, respectively. Proteinuria testing declined with increasing age. Of 604,936 patients who underwent any anemia-related laboratory testing, only 5.1%, 0.4%, and 15.1% had their serum ferritin, transferrin saturation, and serum iron measured, respectively. Among 5219 patients with coded renal anemia, 73.9% received erythropoiesis-stimulating agents (ESAs) or hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs). Notably, 58.6% of 553 patients with a renal anemia diagnosis and hemoglobin levels\u2009\u2265\u200913\u00a0g\/dL were treated with ESAs or HIF-PHIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence\u2013practice gaps in CKD management were identified in Japanese primary care settings, including limited proteinuria testing and raising hemoglobin levels above guideline-recommended limits, despite inadequate evaluation of iron parameters. These findings indicate that systematic quality improvement initiatives are needed to improve CKD management in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10157-026-02851-8","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T12:03:06Z","timestamp":1775217786000},"page":"856-865","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence\u2013practice gaps in chronic kidney disease management among patients taking antidiabetic or antihypertensive medications: a nationwide analysis of Japanese primary care electronic health records"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3831-7241","authenticated-orcid":false,"given":"Takahiro","family":"Imaizumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Asada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumire","family":"Kanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-ichi","family":"Araki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"2851_CR1","unstructured":"Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease 2024. https:\/\/cdn.jsn.or.jp\/medic\/guideline\/pdf\/guide\/viewer.html?file=1-178_v2.pdf. 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Shinji Asada, Hiroki Ono, and Sumire Kanai are employees of Kyowa Kirin Co., Ltd. Shin-ichi Araki received grants from Torii Pharmaceutical Co., Ltd. and Zeria Pharmaceutical Co., Ltd., and honoraria from Kyowa Kirin Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., AstraZeneca K.K., Mitsubishi Tanabe Pharma Corporation, Kowa Company, Ltd., Ono Pharmaceutical Co., Ltd., and Novo Nordisk Pharma Ltd.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol received institutional review board approval in Kyowa Kirin Co., Ltd. (approval number: MA2024_007_00). This study was conducted in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"As this study utilized exclusively anonymized data, the requirement for obtaining informed consent was waived.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}}]}}