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Associations with age and glomerular filtration rate in a referred population with chronic kidney disease: methods and baseline data from a UK multicentre cohort study (NURTuRE-CKD)

Associations with age and glomerular filtration rate in a referred population with chronic kidney disease: methods and baseline data from a UK multicentre cohort study (NURTuRE-CKD)
Associations with age and glomerular filtration rate in a referred population with chronic kidney disease: methods and baseline data from a UK multicentre cohort study (NURTuRE-CKD)

Background. Chronic kidney disease (CKD) is common but heterogenous and is associated with multiple adverse outcomes. The National Unified Renal Translational Research Enterprise (NURTuRE)-CKD cohort was established to investigate risk factors for clinically important outcomes in persons with CKD referred to secondary care. Methods. Eligible participants with CKD stages G3–4 or stages G1–2 plus albuminuria >30 mg/mmol were enrolled from 16 nephrology centres in England, Scotland and Wales from 2017 to 2019. Baseline assessment included demographic data, routine laboratory data and research samples. Clinical outcomes are being collected over 15 years by the UK Renal Registry using established data linkage. Baseline data are presented with subgroup analysis by age, sex and estimated glomerular filtration rate (eGFR). Results. A total of 2996 participants was enrolled. Median (interquartile range) age was 66 (54–74) years, eGFR 33.8 (24.0–46.6) mL/min/1.73 m 2 and urine albumin to creatinine ratio 209 (33–926) mg/g; 58.5% were male. Of these participants, 1883 (69.1%) were in high-risk CKD categories. Primary renal diagnosis was CKD of unknown cause in 32.3%, glomerular disease in 23.4% and diabetic kidney disease in 11.5%. Older participants and those with lower eGFR had higher systolic blood pressure and were less likely to be treated with renin–angiotensin system inhibitors (RASi) but were more likely to receive a statin. Female participants were less likely to receive a RASi or statin. Conclusions. NURTuRE-CKD is a prospective cohort of persons who are at relatively high risk of adverse outcomes. Long-term followup and a large biorepository create opportunities for research to improve risk prediction and to investigate underlying mechanisms to inform new treatment development.

Aged, Albuminuria/epidemiology, England, Female, Glomerular Filtration Rate, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Prospective Studies, Renal Insufficiency, Chronic/etiology, Risk Factors, chronic kidney disease, cohort study, sex, risk profile, albuminuria
0931-0509
2617-2626
Taal, Maarten. W.
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Lucas, Bethany
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Roderick, Paul
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Cockwell, Paul
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Wheeler, David C
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Saleem, Moin A
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Fraser, Simon
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Banks, Rosamonde E
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Johnson, Tim
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Hale, Lorna J
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Andag, Uwe
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Skroblin, Philipp
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Bayerlova, Michaela
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Unwin, Robert
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Vuilleumier, Nicolas
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Dusaulcy, Rodolphe
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Robertson, Fiona
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Colby, Elizabeth
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Pitcher, David
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Braddon, Fiona
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Benavente, Melissa
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Davies, Elaine
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Nation, Michael
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Kalra, Philip A
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Taal, Maarten. W.
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Lucas, Bethany
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Roderick, Paul
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Cockwell, Paul
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Wheeler, David C
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Saleem, Moin A
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Fraser, Simon
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Banks, Rosamonde E
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Johnson, Tim
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Hale, Lorna J
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Andag, Uwe
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Skroblin, Philipp
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Bayerlova, Michaela
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Unwin, Robert
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Vuilleumier, Nicolas
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Dusaulcy, Rodolphe
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Robertson, Fiona
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Colby, Elizabeth
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Pitcher, David
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Braddon, Fiona
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Benavente, Melissa
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Davies, Elaine
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Nation, Michael
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Kalra, Philip A
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Taal, Maarten. W., Lucas, Bethany, Roderick, Paul, Cockwell, Paul, Wheeler, David C, Saleem, Moin A, Fraser, Simon, Banks, Rosamonde E, Johnson, Tim, Hale, Lorna J, Andag, Uwe, Skroblin, Philipp, Bayerlova, Michaela, Unwin, Robert, Vuilleumier, Nicolas, Dusaulcy, Rodolphe, Robertson, Fiona, Colby, Elizabeth, Pitcher, David, Braddon, Fiona, Benavente, Melissa, Davies, Elaine, Nation, Michael and Kalra, Philip A (2023) Associations with age and glomerular filtration rate in a referred population with chronic kidney disease: methods and baseline data from a UK multicentre cohort study (NURTuRE-CKD). Nephrology, Dialysis, Transplantation, 38 (11), 2617-2626. (doi:10.1093/ndt/gfad110).

Record type: Article

Abstract

Background. Chronic kidney disease (CKD) is common but heterogenous and is associated with multiple adverse outcomes. The National Unified Renal Translational Research Enterprise (NURTuRE)-CKD cohort was established to investigate risk factors for clinically important outcomes in persons with CKD referred to secondary care. Methods. Eligible participants with CKD stages G3–4 or stages G1–2 plus albuminuria >30 mg/mmol were enrolled from 16 nephrology centres in England, Scotland and Wales from 2017 to 2019. Baseline assessment included demographic data, routine laboratory data and research samples. Clinical outcomes are being collected over 15 years by the UK Renal Registry using established data linkage. Baseline data are presented with subgroup analysis by age, sex and estimated glomerular filtration rate (eGFR). Results. A total of 2996 participants was enrolled. Median (interquartile range) age was 66 (54–74) years, eGFR 33.8 (24.0–46.6) mL/min/1.73 m 2 and urine albumin to creatinine ratio 209 (33–926) mg/g; 58.5% were male. Of these participants, 1883 (69.1%) were in high-risk CKD categories. Primary renal diagnosis was CKD of unknown cause in 32.3%, glomerular disease in 23.4% and diabetic kidney disease in 11.5%. Older participants and those with lower eGFR had higher systolic blood pressure and were less likely to be treated with renin–angiotensin system inhibitors (RASi) but were more likely to receive a statin. Female participants were less likely to receive a RASi or statin. Conclusions. NURTuRE-CKD is a prospective cohort of persons who are at relatively high risk of adverse outcomes. Long-term followup and a large biorepository create opportunities for research to improve risk prediction and to investigate underlying mechanisms to inform new treatment development.

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Accepted/In Press date: 4 May 2023
e-pub ahead of print date: 25 May 2023
Published date: 1 November 2023
Additional Information: Funding Information: B.L. (Doctoral Fellowship NIHR302626) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.’ Funding Information: NURTuRE is a collaborative project with multiple academic and commercial partners listed in and is governed by a formal collaboration agreement. The NURTuRE collaboration is currently running two cohort studies, the study described in this manuscript (the CKD cohort) and another study recruiting people with idiopathic nephrotic syndrome. The project is coordinated by a Joint Steering Committee which is chaired by a Director from Kidney Research UK and includes representatives from all partners. Funding is provided by the commercial partners. All funds are paid to Kidney Research UK and awarded to the investigators as a research grant. The CKD study is led by an academic steering group comprised of M.W.T., P.C., P.R., S.D.S.F., D.C.W. and P.A.K. Funding Information: B.L. (Doctoral Fellowship NIHR302626) is funded by the National Institute for Health Research (NIHR) for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care.’ This study is supported by funding provided by the commercial partners (see Supplementary data Table S3) to Kidney Research UK through a formal collaboration agreement and awarded to the academic investigators as a research grant. Publisher Copyright: © 2023 Oxford University Press. All rights reserved.
Keywords: Aged, Albuminuria/epidemiology, England, Female, Glomerular Filtration Rate, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Prospective Studies, Renal Insufficiency, Chronic/etiology, Risk Factors, chronic kidney disease, cohort study, sex, risk profile, albuminuria

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Local EPrints ID: 477853
URI: http://eprints.soton.ac.uk/id/eprint/477853
ISSN: 0931-0509
PURE UUID: 61c2a638-64b7-4a59-b5ff-76bdc26b92de
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406

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Date deposited: 15 Jun 2023 16:52
Last modified: 19 Sep 2024 01:41

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Contributors

Author: Maarten. W. Taal
Author: Bethany Lucas
Author: Paul Roderick ORCID iD
Author: Paul Cockwell
Author: David C Wheeler
Author: Moin A Saleem
Author: Simon Fraser ORCID iD
Author: Rosamonde E Banks
Author: Tim Johnson
Author: Lorna J Hale
Author: Uwe Andag
Author: Philipp Skroblin
Author: Michaela Bayerlova
Author: Robert Unwin
Author: Nicolas Vuilleumier
Author: Rodolphe Dusaulcy
Author: Fiona Robertson
Author: Elizabeth Colby
Author: David Pitcher
Author: Fiona Braddon
Author: Melissa Benavente
Author: Elaine Davies
Author: Michael Nation
Author: Philip A Kalra

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