Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.
Validity of estimated prevalence of decreased kidney function and renal replacement therapy from primary care electronic health records compared with national survey and registry data in the United Kingdom.
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DOI：
10.1093/ndt/gfw318
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发表时间：
2017-04-01
期刊：
影响因子：
--
通讯作者：
Nitsch D
中科院分区：
文献类型：
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作者：
Iwagami M;Tomlinson LA;Mansfield KE;Casula A;Caskey FJ;Aitken G;Fraser SDS;Roderick PJ;Nitsch D
匿名初级保健记录是观察性研究的重要资源。然而，它们在确定肾功能下降的患病率和肾脏替代治疗（RRT）方面的外部有效性尚不清楚。因此，我们比较了临床实践研究数据链（CPRD）与全国代表性调查和国家登记中肾功能下降和RRT的患病率。在2014年3月31日在CPRD登记≥1年的所有≥25岁的人群中，我们使用慢性肾病流行病学协作方程，根据他们过去5年的最新血清肌酐，确定肾小球滤过率（eGFR）估计<60 mL/min/1.73 m2的患者和记录诊断为RRT的患者。分母是每个年龄-性别组的整个人群，与肌酐测量无关。将eGFR <60 mL/min/1.73 m2的流行率与2009/2010年英国健康调查（HSE）进行比较，并将RRT的流行率与2014年英国肾脏登记处（UKRR）的流行率进行比较。我们分析了2 761 755例CPRD患者[平均年龄53 （SD 17）岁，男性49%]，其中189 581例（6.86%）eGFR <60 mL/min/1.73 m2, 3293例（0.12%）接受RRT。CPRD中eGFR <60 mL/min/1.73 m2的患病率与HSE相似，RRT的患病率在所有年龄组中与UKRR接近，尽管HSE中eGFR <60 mL/min/1.73 m2的少数年轻患者可能阻碍了精确的比较。英国初级保健数据在肾功能下降和RRT患病率方面具有良好的外部有效性。
Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, according to their most recent serum creatinine in the past 5 years using the Chronic Kidney Disease Epidemiology Collaboration equation and patients with recorded diagnoses of RRT. Denominators were the entire population in each age–sex band irrespective of creatinine measurement. The prevalence of eGFR <60 mL/min/1.73 m2 was compared with that in the Health Survey for England (HSE) 2009/2010 and the prevalence of RRT was compared with that in the UK Renal Registry (UKRR) 2014. We analysed 2 761 755 people in CPRD [mean age 53 (SD 17) years, men 49%], of whom 189 581 (6.86%) had an eGFR <60 mL/min/1.73 m2 and 3293 (0.12%) were on RRT. The prevalence of eGFR <60 mL/min/1.73 m2 in CPRD was similar to that in the HSE and the prevalence of RRT was close to that in the UKRR across all age groups in men and women, although the small number of younger patients with an eGFR <60 mL/min/1.73 m2 in the HSE might have hampered precise comparison. UK primary care data have good external validity for the prevalence of decreased kidney function and RRT.