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

BMC Nephrology

John P Ferguson⁴  Gemma Browne¹  Howard Johnson⁵  Rajiv Saran²  Ailish Hannigan⁴  Walter Cullen⁴  Tetyana Chernenko⁴  Cornelius J Cronin⁴  Liam F Casserly⁴  Austin G Stack³ 

[1] Department of Epidemiology and Public Health, University College Cork, Cork, Ireland;Kidney Epidemiology and Cost Center, School of Public Health, University of Michigan, Ann Arbor, MI, USA;Department of Medicine, Clinical Academic Liaison Building, St Nessans Rd, Limerick, Ireland;Graduate Entry Medical School, University of Limerick, Limerick, Ireland;Health Intelligence Unit, Health Services Executive, Dublin, Ireland

关键词: Risk factors;    Epidemiology;    Health system;    CKD surveillance;   

Others  :  1082558
DOI  :  10.1186/1471-2369-15-185

 received in 2014-03-22, accepted in 2014-10-29,  发布年份 2014

【 摘 要 】

Background

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%, P < 0.001), older age groups, and among patients with a history of Acute Kidney Injury (AKI) than without (45.2% versus 10.7%, P < 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 outcomes.

【 授权许可】

   
2014 Stack et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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