Prevalence and variation of Chronic Kidney Disease in the Irish health system: initial findings from the National Kidney Disease Surveillance Programme

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dc.contributor.authorStack, Austin G.
dc.contributor.authorCasserly, Liam F.
dc.contributor.authorCronin, Cornelius J.
dc.contributor.authorChernenko, Tetyana
dc.contributor.authorCullen, Walter
dc.contributor.authorHannigan, Ailish
dc.contributor.authorSaran, Rajiv
dc.contributor.authorJohnson, Howard
dc.contributor.authorBrowne, Gemma
dc.contributor.authorFerguson, John P.
dc.contributor.funderHealth Research Boarden
dc.contributor.funderUniversity Hospital Limericken
dc.date.accessioned2016-01-20T10:42:52Z
dc.date.available2016-01-20T10:42:52Z
dc.date.issued2014-11-25
dc.description.abstractBACKGROUND: Chronic Kidney Disease (CKD) is a major non-communicable chronic disease that is associated with adverse clinical and economic outcomes. Passive surveillance systems are likely to improve efforts for prevention of chronic kidney disease (CKD) and inform national service planning. This study was conducted to determine the overall prevalence of CKD in the Irish health system, assess period trends and explore patterns of variation as part of a novel surveillance initiative. METHODS: We identified 207, 336 adult patients, age 18 and over, with serum creatinine measurements recorded from a provincial database between 2005-2011 in the Northwest of Ireland. Estimated glomerular filtration rates (eGFR) were determined using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation from standardized creatinine measurements and the presence of CKD was defined as eGFR <60 ml/min per 1.73 m2. Age and sex-specific prevalence estimates were determined for each group while generalized estimating equations (GEE) and multivariable logistic regression were used to explore associations using adjusted odds ratios (AOR) and 95% confidence intervals (95% CI). RESULTS: The prevalence of CKD in the health system was 11.8% (95% CI 11.8-12.1); 10.9% in men (10.7-11.1) and 12.6% in women (12.4-12.8). This corresponded to a detection rate of 4.5% (5.1% in women and 3.9% in men). The prevalence of CKD was significantly higher in women than in men (12.6% versus 10.9%, Pā€‰<ā€‰0.001), older age groups, and among patients with a history of Acute Kidney Injury (AKI) than without (45.2% versus 10.7%, Pā€‰<ā€‰0.0001). Multivariable analysis identified advancing age, female gender, location of medical supervision, county of residence, and AKI as significant determinants of prevalence. CONCLUSION: The prevalence of CKD in the Irish health system is 11.8% corresponding to a detection rate of 4.5% in the general population. Demographic, geographic factors and acute kidney injury episodes are important determinants of disease burden. Passive surveillance of CKD is both feasible and desirable within the Irish health system, and offers huge opportunities for targeted prevention programmes and improved clinical outcomesen
dc.description.sponsorshipHealth Research Board (HRA-2013-PHR-437); Medical Education Liaison Group (MELG) University Hospital Limerick.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid185
dc.identifier.citationSTACK, A. G., CASSERLY, L. F., CRONIN, C. J., CHERNENKO, T., CULLEN, W., HANNIGAN, A., SARAN, R., JOHNSON, H., BROWNE, G. & FERGUSON, J. P. 2014. Prevalence and variation of Chronic Kidney Disease in the Irish health system: initial findings from the National Kidney Disease Surveillance Programme. BMC Nephrology, 15:185, 1-12. http://dx.doi.org/10.1186/1471-2369-15-185en
dc.identifier.doi10.1186/1471-2369-15-185
dc.identifier.endpage12en
dc.identifier.issn1471-2369
dc.identifier.journaltitleBMC Nephrologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/2199
dc.identifier.volume15en
dc.language.isoenen
dc.publisherBiomed Central Ltd.en
dc.rightsĀ© 2014 Stack et al.; licensee BioMed Central Ltd., 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCKD surveillanceen
dc.subjectHealth systemen
dc.subjectEpidemiologyen
dc.subjectRisk factorsen
dc.subjectGlomerular filtration rateen
dc.subjectSerum creatinineen
dc.subjectAcute kidney failureen
dc.subjectChronic kidney diseaseen
dc.subjectCreatinine blood levelen
dc.subjectDisease surveillanceen
dc.subjectHealth care systemen
dc.subjectIrish citizenen
dc.subjectRenal systemen
dc.subjectSex differenceen
dc.subjectMaleen
dc.subjectFemaleen
dc.subjectComparative studyen
dc.subjectControlled studyen
dc.subjectRetrospective studyen
dc.subjectMajor clinical studyen
dc.subjectGlomerulus filtration rateen
dc.titlePrevalence and variation of Chronic Kidney Disease in the Irish health system: initial findings from the National Kidney Disease Surveillance Programmeen
dc.typeArticle (peer-reviewed)en
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