Association of continuity of care with blood pressure control in patients with chronic kidney disease and hypertension

Background and objectives: Kidney Health Australia recommends regular monitoring of patients with chronic kidney disease (CKD) to reduce progression and prevent complications such as cardiovascular disease. The objective of this study was to examine how practice aligns with the recommendations in Kidney Health Australia’s CKD guidelines.

Methods: Australian general practice data from the NPS MedicineWise MedicineInsight program (1 January 2013 – 1 June 2016) for 19,712 adults with laboratory evidence of stage 3 CKD were analysed. Complete monitoring in these individuals was defined as having at least one recorded assessment of blood pressure, urine albumin-to-creatinine ratio, estimated glomerular filtration rate and serum lipids over an 18-month period.

Results: Complete monitoring was performed for 25% of the cohort; 54.9% among patients with concomitant diabetes and 14.1% among patients without diabetes. Patients with diabetes, hypertension and a documented diagnosis of CKD were more likely to have complete monitoring.

Discussion: There is room for improvement in monitoring of patients with stage 3 CKD, particularly for albuminuria, which was monitored in fewer than 50% of these patients.