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The epidemiology of diagnosed chronic renal failure in Southampton and Southwest Hampshire Health Authority

The epidemiology of diagnosed chronic renal failure in Southampton and Southwest Hampshire Health Authority
The epidemiology of diagnosed chronic renal failure in Southampton and Southwest Hampshire Health Authority

The study comprised an investigation of the incidence of chronic renal failure (CRF) in a defined English health authority and a retrospective cohort of newly incident cases of CRF.

Incidence rates were derived from new cases in Southampton Health Authority (pop 404,547) 1992-94, as determined by a raised serum creatinine (SCr 150 mmol/L) from chemical pathology records. A retrospective study of all diagnosed CRF (n=1076) and a randomly selected sub-cohort (n=213) for detailed medial note search. Follow-up was until 31/12/98, mean 5 ½ years. Outcomes were mortality, referral to nephrologists and acceptance on to renal replacement therapy (RRT).

The median age was 77, overall rate of CRF 1330 (1253-1412) per million population and the M:F rate ratio was 1.6 (1.4-1.8). Areas of high social deprivation had higher rates of CRF. By 31/12/98, 741 (69%) of cases had died. Less than 50% of cases are referred to a nephrologist with age and co-morbidity being negatively associated with referral. Acceptance for renal replacement therapy was also negatively associated with increasing age.

CRF is relatively common especially in men, the elderly, those in deprived areas and amongst South Asians. Survival is poor in CRF. Mortality is high, 66% mortality at five years, with an excess in younger age groups and in women. Most cases never see a nephrologist and there is scope to increase referral by four times the current rate. Routine data were found to be incomplete and inaccurate requiring extensive cross-checking and validation. Investment is needed to improve the quality of routine data in the NHS.

University of Southampton
Drey, Nicholas St John
22d0d492-ef48-4836-b9af-44df82d19d60
Drey, Nicholas St John
22d0d492-ef48-4836-b9af-44df82d19d60

Drey, Nicholas St John (2000) The epidemiology of diagnosed chronic renal failure in Southampton and Southwest Hampshire Health Authority. University of Southampton, Doctoral Thesis.

Record type: Thesis (Doctoral)

Abstract

The study comprised an investigation of the incidence of chronic renal failure (CRF) in a defined English health authority and a retrospective cohort of newly incident cases of CRF.

Incidence rates were derived from new cases in Southampton Health Authority (pop 404,547) 1992-94, as determined by a raised serum creatinine (SCr 150 mmol/L) from chemical pathology records. A retrospective study of all diagnosed CRF (n=1076) and a randomly selected sub-cohort (n=213) for detailed medial note search. Follow-up was until 31/12/98, mean 5 ½ years. Outcomes were mortality, referral to nephrologists and acceptance on to renal replacement therapy (RRT).

The median age was 77, overall rate of CRF 1330 (1253-1412) per million population and the M:F rate ratio was 1.6 (1.4-1.8). Areas of high social deprivation had higher rates of CRF. By 31/12/98, 741 (69%) of cases had died. Less than 50% of cases are referred to a nephrologist with age and co-morbidity being negatively associated with referral. Acceptance for renal replacement therapy was also negatively associated with increasing age.

CRF is relatively common especially in men, the elderly, those in deprived areas and amongst South Asians. Survival is poor in CRF. Mortality is high, 66% mortality at five years, with an excess in younger age groups and in women. Most cases never see a nephrologist and there is scope to increase referral by four times the current rate. Routine data were found to be incomplete and inaccurate requiring extensive cross-checking and validation. Investment is needed to improve the quality of routine data in the NHS.

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Published date: 2000

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Local EPrints ID: 467020
URI: http://eprints.soton.ac.uk/id/eprint/467020
PURE UUID: 5e81954e-9911-4ea0-885e-a0ebbea2091d

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Date deposited: 05 Jul 2022 08:08
Last modified: 16 Mar 2024 20:56

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Author: Nicholas St John Drey

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