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Unreferred chronic kidney disease: a longitudinal study
Robert John1, Michelle Webb, Alan Young
1Department of Renal Medicine, Kent and Canterbury Hospital, Canterbury, Kent, USA.
Summary
Most patients with moderate to severe chronic kidney disease (CKD) are undiagnosed. Management strategies for CKD should focus on primary and secondary care collaboration for better outcomes.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic kidney disease (CKD) poses a significant global health challenge.
- Understanding CKD epidemiology and outcomes is crucial for effective management.
- Current strategies require refinement for diverse CKD stages.
Purpose of the Study:
- To investigate the epidemiological characteristics of moderate to severe CKD.
- To determine adverse outcomes in undiagnosed CKD patients.
- To assess the impact of referral on CKD patient survival and GFR.
Main Methods:
- Defined moderate to severe CKD using serum creatinine (SCr) thresholds in a UK population.
- Identified patients unknown to renal services and followed them for survival and GFR.
- Analyzed referral rates and factors associated with poor outcomes.
Main Results:
- CKD prevalence was 5,554 per million population (pmp).
- 84.8% of identified CKD patients were unknown to renal services.
- Non-referral, male sex, and low GFR were linked to poorer survival; anemia was common.
Conclusions:
- Universal referral for all CKD patients is impractical.
- Collaborative management between primary and secondary care is essential.
- Developing targeted strategies for undiagnosed CKD is necessary to improve outcomes.