Chronic kidney disease in primary care: outcomes after five years in a prospective cohort study

Shardlow, Adam; McIntyre, Natasha J.; Fluck, Richard J.; McIntyre, Christopher W.; Taal, Maarten W.

Abstract

Background

Chronic kidney disease (CKD) is commonly managed in primary care, but most guidelines have a secondary care perspective emphasizing the risk of end-stage kidney disease (ESKD) and need for renal replacement therapy. In this prospective cohort study, we sought to study in detail the natural history of CKD in primary care to better inform the appropriate emphasis for future guidance.

Methods and Findings

In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom. Study visits were undertaken at baseline, year 1, and year 5. Binomial logistic regression and Cox proportional hazards models were used to model progression, CKD remission, and all-cause mortality. We used Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define CKD progression and defined CKD remission as the absence of diagnostic criteria (estimated glomerular filtration rate [eGFR] >60 ml/min/1.73 m2 and urine albumin-to-creatinine ratio [uACR]

Citation

Shardlow, A., McIntyre, N. J., Fluck, R. J., McIntyre, C. W., & Taal, M. W. (2016). Chronic kidney disease in primary care: outcomes after five years in a prospective cohort study. PLoS Medicine, 13(9), 1-16. https://doi.org/10.1371/journal.pmed.1002128

• Journal Article Type: Article
• Acceptance Date: Aug 12, 2016
• Online Publication Date: Sep 20, 2016
• Publication Date: Sep 20, 2016
• Deposit Date: Feb 6, 2017
• Publicly Available Date: Feb 6, 2017
• Journal: PLOS Medicine
• Print ISSN: 1549-1277
• Electronic ISSN: 1549-1676
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Issue: 9
• Article Number: 1002128
• Pages: 1-16
• DOI: https://doi.org/10.1371/journal.pmed.1002128
• Public URL: https://nottingham-repository.worktribe.com/output/816909
• Publisher URL: http://dx.doi.org/10.1371/journal.pmed.1002128