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A population-based study of the incidence and outcomes of diagnosed chronic kidney disease

A population-based study of the incidence and outcomes of diagnosed chronic kidney disease
A population-based study of the incidence and outcomes of diagnosed chronic kidney disease
Background: This study aims to determine the incidence rate and prognosis of detected chronic kidney disease (CKD) in a defined population.
Methods: This is a retrospective cohort study of all new cases of CKD from Southampton and South-West Hampshire Health Authority (population base, 405,000) determined by a persistently increased serum creatinine (SCr) level (?1.7 mg/dL [?150 µmol/L] for 6 months) identified from chemical pathology records. Follow-up was for a mean of 5.5 years for survival, cause of death, and acceptance to renal replacement therapy (RRT).
Results: The annual incidence rate of detected CKD was 1,701 per million population (pmp; 95% confidence interval [CI], 1,613 to 1,793) and 1,071 pmp (95% CI, 1,001 to 1,147) in those younger than 80 years. There was a steep age gradient; median age was 77 years. The man-woman rate ratio was 1.6 (95% CI, 1.4 to 1.8), with a male excess in all age groups older than 40 years. Incidence increased in areas with greater socioeconomic deprivation. Median survival was 35 months. Age, SCr level, and deprivation index were all significantly associated with survival. Standardized mortality ratios were 36-fold in those aged 16 to 49 years, 12-fold in those aged 50 to 64 years, and more than 2-fold in those older than 65 years. Cardiovascular disease (CVD) was the most common cause of death (46%). Only 4% of patients were accepted to RRT.
Conclusion: The incidence of diagnosed CKD is common, especially in the elderly, and is greater in more deprived areas. Prognosis is poor, with CVD prominent. More research is needed to assess the effectiveness and costs of increasing referral to nephrologists of patients with CKD.
0272-6386
677-684
Drey, Nicholas
39887d7b-c86f-42a4-b3a5-8f04e66a6e63
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Rogerson, Mary
37d0a242-f479-4d8c-9a5c-5b9e4d5dca16
Drey, Nicholas
39887d7b-c86f-42a4-b3a5-8f04e66a6e63
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Rogerson, Mary
37d0a242-f479-4d8c-9a5c-5b9e4d5dca16

Drey, Nicholas, Roderick, Paul, Mullee, Mark and Rogerson, Mary (2003) A population-based study of the incidence and outcomes of diagnosed chronic kidney disease. American Journal of Kidney Diseases, 42 (4), 677-684.

Record type: Article

Abstract

Background: This study aims to determine the incidence rate and prognosis of detected chronic kidney disease (CKD) in a defined population.
Methods: This is a retrospective cohort study of all new cases of CKD from Southampton and South-West Hampshire Health Authority (population base, 405,000) determined by a persistently increased serum creatinine (SCr) level (?1.7 mg/dL [?150 µmol/L] for 6 months) identified from chemical pathology records. Follow-up was for a mean of 5.5 years for survival, cause of death, and acceptance to renal replacement therapy (RRT).
Results: The annual incidence rate of detected CKD was 1,701 per million population (pmp; 95% confidence interval [CI], 1,613 to 1,793) and 1,071 pmp (95% CI, 1,001 to 1,147) in those younger than 80 years. There was a steep age gradient; median age was 77 years. The man-woman rate ratio was 1.6 (95% CI, 1.4 to 1.8), with a male excess in all age groups older than 40 years. Incidence increased in areas with greater socioeconomic deprivation. Median survival was 35 months. Age, SCr level, and deprivation index were all significantly associated with survival. Standardized mortality ratios were 36-fold in those aged 16 to 49 years, 12-fold in those aged 50 to 64 years, and more than 2-fold in those older than 65 years. Cardiovascular disease (CVD) was the most common cause of death (46%). Only 4% of patients were accepted to RRT.
Conclusion: The incidence of diagnosed CKD is common, especially in the elderly, and is greater in more deprived areas. Prognosis is poor, with CVD prominent. More research is needed to assess the effectiveness and costs of increasing referral to nephrologists of patients with CKD.

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Published date: October 2003

Identifiers

Local EPrints ID: 24326
URI: https://eprints.soton.ac.uk/id/eprint/24326
ISSN: 0272-6386
PURE UUID: 7d9e6d95-cb93-41a0-8f93-af8fb7ed7791
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 30 Mar 2006
Last modified: 06 Jun 2018 13:05

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