Chronic kidney disease management in the United Kingdom: NEOERICA project results

Early identification of patients with chronic kidney disease (CKD) may allow health-care systems to implement interventions aimed at decreasing disease progression and eventual morbidity and mortality. Primary care in the United Kingdom is computerized suggesting a separate screening program for CKD...

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Bibliographic Details
Published in:	Kidney international 2007-07, Vol.72 (1), p.92-99
Main Authors:	Stevens, P.E., O'Donoghue, D.J., de Lusignan, S., Van Vlymen, J., Klebe, B., Middleton, R., Hague, N., New, J., Farmer, C.K.T.
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Aged Aged, 80 and over Anemia - complications Anemia - diagnosis cardiovascular disease Cardiovascular Diseases - complications Cardiovascular Diseases - diagnosis Chronic Disease chronic kidney disease computerized medical record Creatinine - blood Diabetes Complications - complications Diabetes Complications - diagnosis Diagnosis, Computer-Assisted - methods Disease Progression estimated glomerular filtration rate Female Glomerular Filtration Rate - physiology Hemoglobins - metabolism Humans hypertension Hypertension - complications Hypertension - diagnosis Kidney - metabolism Kidney - physiopathology Kidney Diseases - diagnosis Kidney Diseases - etiology Kidney Diseases - therapy Male Mass Screening - methods medicines management Middle Aged Retrospective Studies Risk Factors United Kingdom
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Summary:	Early identification of patients with chronic kidney disease (CKD) may allow health-care systems to implement interventions aimed at decreasing disease progression and eventual morbidity and mortality. Primary care in the United Kingdom is computerized suggesting a separate screening program for CKD may not be necessary because identifying data already populates primary care databases. Our study utilized a data set of 163 demographic, laboratory, diagnosis, and prescription variables from 130 226 adults in the regions of Kent, Manchester, and Surrey. The patients were 18 years of age and older in a 5-year study period culminating in November 2003. Estimated glomerular filtration rate was calculated from the four-variable Modification of Diet in Renal Disease equation using calibrated creatinine levels. A valid creatinine value was recorded in almost 30% of this cohort. The age-standardized prevalence of stage 3–5 CKD was 10.6% for females and 5.8% for males. In these patients, the odds ratio for hypertension was 2.1, for diabetes 1.33, and for cardiovascular disease 1.69. Only 20% of the diabetic people with stage 3–5 CKD had a blood pressure less than or equal to 130/80 mm Hg. The proportion of patients with anemia significantly rose as renal function declined. We suggest that stage 3–5 CKD is easily detected in existing computerized records. The associated comorbidity and management is readily available enabling intervention and targeting of specialist resources.
ISSN:	0085-2538 1523-1755