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Prevalence of advanced renal failure in Northern Ireland
1Queen's University of Belfast.
Insights
The prevalence of advanced chronic renal failure (ACRF) has increased, particularly in older adults. This rise in ACRF cases, especially among the elderly, presents significant resource implications for healthcare services.
Area of Science:
- Nephrology
- Public Health
- Epidemiology
Background:
- Chronic renal failure (CRF) is a significant health concern requiring accurate prevalence data for service planning.
- Previous studies have established baseline data for CRF in Northern Ireland.
Purpose of the Study:
- To determine the current prevalence of advanced chronic renal failure (ACRF) in Northern Ireland.
- To assess the level of service provision for patients with ACRF.
Main Methods:
- Prospective notification of patients meeting defined ACRF criteria (serum creatinine ≥ 500 μmol/l or blood urea ≥ 25 mmol/l).
- Follow-up of patients for 3-4 years post-notification.
- Study setting: Northern Ireland.
Main Results:
- The prevalence of ACRF was 77 patients/million population/year, an increase from a previous study (67/million/year).
- 62% of new ACRF patients were over 50 years old.
- 14% of patients required dialysis or died within one month; 19% survived for one year or longer.
Conclusions:
- The increase in ACRF prevalence is primarily attributed to a rise in older patients.
- Older patients with ACRF often have comorbidities, require more intensive care, and may not be suitable for transplantation.
- These factors have considerable resource implications for the National Health Service (NHS).
Objective:
To determine the prevalence of advanced chronic renal failure in Northern Ireland as part of an assessment by the Renal Association of the level of service provision for treatment of such patients.
Design:
Prospective notification of patients reaching a defined level of advanced chronic renal failure (serum creatinine concentration greater than or equal to 500 mumol/l or blood urea concentration greater than or equal to 25 mmol/l) within one year and follow up for at least three, and, at most, four years after notification.
Setting:
Northern Ireland.
Patients:
122 Patients with a serum creatinine or blood urea concentration higher than the defined level newly detected from 1 March 1985 to 28 February 1986.
Main Outcome Measure:
Survival after notification.
Results:
77 Patients of all ages/million population/year had advanced chronic renal failure compared with 67/million/year between the ages of 5 and 80 found in an earlier study of the same population. 62% Of the patients were older than 50 years. Seventeen (14%) of the patients either required dialysis or died within one month of notification, 51 (42%) survived for at least three months, and 23 (19%) for one year or longer. Three patients, all of whom were attending a renal clinic, survived for periods of 43, 45, and 46 months respectively without renal replacement treatment.
Conclusions:
The increased number of new patients disclosed in this survey compared with the earlier survey is mainly owing to an increased number of older patients. Such patients often have disabilities other than renal failure, are less likely to be capable of self treatment, may develop complications more often and require more frequent hospital admissions, and may not be suitable for transplantation and consequently have considerable resource implications for the NHS.
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