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Factors associated with chronic kidney disease progression in Australian nephrology practices

Citation

Boudville, N and Kemp, A and Moody, H and Fassett, RG and Pedagogos, E and Nelson, C and Healy, H and Mangos, G and Kirkland, G and Kay, T and Champion De Crespigny, P and Hoffman, D and Waugh, D, Factors associated with chronic kidney disease progression in Australian nephrology practices, Nephron - Clinical Practice, 121, (1-2) pp. c36-c41. ISSN 1660-2110 (2012) [Refereed Article]

DOI: doi:10.1159/000342375

Abstract

Background/Aims: Chronic kidney disease (CKD) is a major health issue worldwide. The aim of this study was to explore factors associated with CKD progression in Australian nephrology practices.

Methods: This was a retrospective study utilising an electronic medical record (EMR), Audit4 (Software for Specialists, Australia). The baseline visit was defined as the first entry into the EMR. The primary outcome was the rate of change in estimated glomerular filtration rate (eGFR).

Results: 1,328 patients were included with a mean eGFR at baseline of 37.4 0.7 ml/min/1.73 m2, a mean follow-up of 17.7 months and a mean annual rate of change in eGFR of -0.84 0.26 ml/min/1.73 m2. Univariate analysis demonstrated that women, smokers, and patients prescribed erythropoiesis-stimulating agents (ESA) had a significantly more rapid decline in eGFR (p = 0.007, 0.033, and 0.003, respectively). On multivariate analysis: gender, age, prescription of ESA and phosphate binders, and baseline eGFR were significantly associated with CKD progression (p = 0.003, 0.004, <0.001, 0.029, and <0.001, respectively).

Conclusions: This study identifies potential factors associated with CKD progression in a population referred to nephrologists, but current data quality may result in bias. Implementation of changes in the format of data collection is required so that busy clinicians record essential information to enable this to become a more accurate and reliable research tool.

Item Details

Item Type:Refereed Article
Keywords:chronic kidney failure, disease progression, electronic health records, natural history
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Nephrology and Urology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
Author:Kirkland, G (Dr Geoffrey Kirkland)
ID Code:85074
Year Published:2012
Web of Science® Times Cited:2
Deposited By:Research Division
Deposited On:2013-06-13
Last Modified:2013-06-22
Downloads:0

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