Prevalence and management of chronic kidney disease in primary care patients in the UK
Prevalence and management of chronic kidney disease in primary care patients in the UK
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DOI：
10.1111/ijcp.12454
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发表时间：
2014-09-01
影响因子：
2.6
通讯作者：
O'Donoghue, D.
中科院分区：
文献类型：
--
作者：
Jameson, K.;Jick, S.;O'Donoghue, D.
背景：本研究旨在估算 2010 年英国慢性肾脏病 (CKD) 的患病率，并在将 CKD 纳入质量和结果框架 (QOF) 后评估随时间推移与该疾病相关的患病率、合并症和并发症。方法：这是一项回顾性纵向研究，评估 2010 年全科医学研究数据库 (GPRD) 中患有普遍或偶发 CKD 的个体（使用估计肾小球滤过率读数和/或 Read 代码进行识别）。在两个时间点对个体进行评估：2010 年和 GPRD 中首次对 CKD 进行分类之日。结果：2010年3-5期CKD患病率为5.9%。在首次分类时处于 3-5 期 CKD 的患者中，到 2010 年，大约有 50%、10-15% 和 25-30% 的患者的疾病保持稳定、进展或改善。随着疾病严重程度的恶化，心血管相关合并症（高血压、高胆固醇血症、糖尿病和心血管疾病）的诊断以及抗高血压药物和调脂疗法（LMT）的治疗也随之增加。当按诊断日期对患者进行分层时，患有3-5期CKD和心血管相关合并症的患者比例随着时间的推移而下降，而高胆固醇血症和高血压患者中LMT和抗高血压药物的相对使用随着时间的推移而增加。结论：慢性肾脏病总体上是稳定的或进行性的，尽管更多的患者改善疾病阶段的情况比之前假设的要多。数据表明，将 CKD 引入 QOF 提高了英国医生对 CKD 的认识，从而可以更早干预并更好地控制 CKD 进展。
Background: This study aimed to estimate the prevalence of chronic kidney disease (CKD) in the UK in 2010 and to assess prevalence, comorbidities and comedications associated with the disease over time, following inclusion of CKD in the Quality and Outcomes Framework (QOF). Methods: This was a retrospective, longitudinal study assessing individuals with prevalent or incident CKD (identified using estimated glomerular filtration rate readings and/or Read codes) in the General Practice Research Database (GPRD) in 2010. Individuals were assessed at two time points: in 2010 and at the date of their first classification of CKD in the GPRD. Results: The prevalence of stage 3-5 CKD in 2010 was 5.9%. In patients with stage 3-5 CKD at first classification, their disease remained stable, progressed or improved by 2010 in approximately 50%, 10-15% and 25-30% of patients, respectively. Diagnoses of cardiovascular-related comorbidities (hypertension, hypercholesterolaemia, diabetes and cardiovascular disease), and treatment with antihypertensives and lipid-modifying therapy (LMT), increased with worsening disease severity. When patients were stratified by diagnosis date, the proportion of patients with stage 3-5 CKD and cardiovascular-related comorbidities decreased with time, and the relative use of LMT and antihypertensives among patients with hypercholesterolaemia and hypertension increased with time. Conclusions: Chronic kidney disease is generally stable or progressive, although more patients improve disease stage than previously assumed. Data suggest that the introduction of CKD into the QOF has increased awareness of CKD among physicians in the UK, allowing for earlier intervention and better control of CKD progression.