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Characteristics, ma...
Characteristics, management and outcomes in patients with CKD in a healthcare region in Sweden: a population-based, observational study
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- Agvall, B. (author)
- Halland Hospital Halmstad, Halmstad, Sweden
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- Ashfaq, Awais, 1990- (author)
- Högskolan i Halmstad,Akademin för informationsteknologi
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- Bjurstrom, K. (author)
- Halland Hospital Halmstad, Halmstad, Sweden
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- Etminani, Kobra, 1984- (author)
- Högskolan i Halmstad,Akademin för informationsteknologi
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- Friberg, L. (author)
- AstraZeneca, Stockholm, Sweden
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- Liden, J. (author)
- AstraZeneca, Stockholm, Sweden
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- Lingman, Markus, 1975 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Halland Hospital, Region Halland, Halmstad, Sweden
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(creator_code:org_t)
- London : BMJ Publishing Group Ltd, 2023
- 2023
- English.
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In: Bmj Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 13:7
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Abstract
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- ObjectivesTo describe chronic kidney disease (CKD) regarding treatment rates, comorbidities, usage of CKD International Classification of Diseases (ICD) diagnosis, mortality, hospitalisation, evaluate healthcare utilisation and screening for CKD in relation to new nationwide CKD guidelines. DesignPopulation-based observational study. SettingHealthcare registry data of patients in Southwest Sweden. ParticipantsA total cohort of 65 959 individuals aged >18 years of which 20 488 met the criteria for CKD (cohort 1) and 45 470 at risk of CKD (cohort 2). Primary and secondary outcome measuresData were analysed with regards to prevalence, screening rates of blood pressure, glucose, estimated glomerular filtration rate (eGFR), Urinary-albumin-creatinine ratio (UACR) and usage of ICD-codes for CKD. Mortality and hospitalisation were analysed with logistic regression models. ResultsOf the CKD cohort, 18% had CKD ICD-diagnosis and were followed annually for blood pressure (79%), glucose testing (76%), eGFR (65%), UACR (24%). UACR follow-up was two times as common in hypertensive and cardiovascular versus diabetes patients with CKD with a similar pattern in those at risk of CKD. Statin and renin-angiotensin-aldosterone inhibitor appeared in 34% and 43%, respectively. Mortality OR at CKD stage 5 was 1.23 (CI 0.68 to 0.87), diabetes 1.20 (CI 1.04 to 1.38), hypertension 1.63 (CI 1.42 to 1.88), atherosclerotic cardiovascular disease (ASCVD) 1.84 (CI 1.62 to 2.09) associated with highest mortality risk. Hospitalisation OR in CKD stage 5 was 1.96 (CI 1.40 to 2.76), diabetes 1.15 (CI 1.06 to 1.25), hypertension 1.23 (CI 1.13 to 1.33) and ASCVD 1.52 (CI 1.41 to 1.64). ConclusionsThe gap between patients with CKD by definition versus those diagnosed as such was large. Compared with recommendations patients with CKD have suboptimal follow-up and treatment with renin-angiotensin-aldosterone system inhibitor and statins. Hypertension, diabetes and ASCVD were associated with increased mortality and hospitalisation. Improved screening and diagnosis of CKD, identification and management of risk factors and kidney protective treatment could affect clinical and economic outcomes.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- chronic renal failure
- quality in health care
- health economics
- risk
- management
- diabetic nephropathy & vascular disease
- chronic kidney-disease
- glomerular-filtration-rate
- heart-failure
- age
- metaanalysis
- prevalence
- General & Internal Medicine
- chronic renal failure
- Information driven care
Publication and Content Type
- ref (subject category)
- art (subject category)
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Agvall, B.
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Ashfaq, Awais, 1 ...
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Bjurstrom, K.
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Etminani, Kobra, ...
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Friberg, L.
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Liden, J.
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Lingman, Markus, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
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Bmj Open
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University of Gothenburg
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Halmstad University