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Article ; Online: Identification of factors associated with high-cost use of inpatient care in chronic kidney disease: a registry study.

Sowa, P Marcin / Venuthurupalli, Sree K / Hoy, Wendy E / Zhang, Jianzhen / Cameron, Anne / Healy, Helen G / Connelly, Luke B

BMJ open

2021 Volume 11, Issue 8, Page(s) e049755

Abstract: Objective: To explore factors behind inpatient admissions by high-cost users (HCUs) in pre-end-stage chronic kidney disease (CKD).: Design: Retrospective analysis of CKD.QLD Registry and hospital admissions of the Queensland Government Department of ... ...

Abstract	Objective: To explore factors behind inpatient admissions by high-cost users (HCUs) in pre-end-stage chronic kidney disease (CKD). Design: Retrospective analysis of CKD.QLD Registry and hospital admissions of the Queensland Government Department of Health recorded between 1 July 2011 and 30 June 2016. Setting: Queensland public and private hospitals. Participants: 5096 individuals with CKD who consented to the CKD.QLD Registry via 1 of 11 participating sites. Main outcomes: Associations of HCU status with patient characteristics, pathways and diagnoses behind hospital admissions at 12 months. Results: Age, advanced CKD, primary renal diagnosis, cardiovascular disease and hypertension were predictors of the high-cost outcome. HCUs were more likely than non-HCUs to be admitted by means of episode change (relative risk: 5.21; 95% CI 5.02 to 5.39), 30-day readmission (2.19; 2.13 to 2.25), scheduled readmission (1.29; 1.11 to 1.46) and emergency (1.07; 1.02 to 1.13), for diagnoses of the nervous (1.94; 1.74 to 2.15), circulatory (1.24; 1.14 to 1.34) and respiratory (1.2; 1.03 to 1.37) systems and other factors influencing health status (1.92; 1.74 to 2.09). Conclusions: The high relevance of episode change and other factors influencing health status revealed that a substantial part of excess demand for inpatient care was associated with discordant conditions often linked to frailty, decline in psychological health and social vulnerability. This suggests that multidisciplinary models of care that aim to manage discordant comorbidities and address psychosocial determinants of health, such as renal supportive care, may play an important role in reducing inpatient admissions in this population.
MeSH term(s)	Hospitalization ; Humans ; Inpatients ; Registries ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/therapy ; Retrospective Studies
Language	English
Publishing date	2021-08-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-049755
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Article ; Online: Chronic kidney disease, Queensland: Profile of patients with chronic kidney disease from regional Queensland, Australia: A registry report.

Venuthurupalli, Sree K / Healy, Helen / Fassett, Robert / Cameron, Anne / Wang, Zaimin / Hoy, Wendy E

Nephrology (Carlton, Vic.)

2019 Volume 24, Issue 12, Page(s) 1257–1264

Abstract: Background: Chronic kidney disease, Queensland (CKD.QLD) is a multidisciplinary, collaborative research platform for CKD in Queensland. Most public renal services contribute towards the CKD Registry, including Toowoomba Hospital, which is a referral ... ...

Abstract	Background: Chronic kidney disease, Queensland (CKD.QLD) is a multidisciplinary, collaborative research platform for CKD in Queensland. Most public renal services contribute towards the CKD Registry, including Toowoomba Hospital, which is a referral hospital for Darling Downs Health serving a largely regional population in Queensland. We aim to present the profile of the CKD cohort recruited to the CKD.QLD Registry from Toowoomba Hospital, the first comprehensive report on a pre-dialysis population from regional Australia. Methods: Study subjects were patients in the Darling Downs Health Service who consented to be included in the CKD.QLD registry from June 2011 to December 2016. Those who were on renal replacement therapy (RRT) were excluded. Patients were followed until date of RRT, death, discharge or loss to follow up or a censor date of 30th June 2017. Results: Overall 1051 subjects, representing 13% of all CKD.QLD Registry patients gave consent of whom, 42.7% were ≥70 years of age. The mean age was 63.8 ± 15.1 years (median age 67 years) with male predominance (55.4%). The majority were born in Australia (86.4%). Aboriginal and Torre Strait Islanders (A&TSI) constituted 9.6% of the cohort. The predominant CKD stages were 3b (28.9%) and 4 (27.7%). Hypertension and diabetes were noted in 91% and 44% of subjects, respectively. Diabetic nephropathy was the leading cause of CKD (26.7%) followed by renovascular disease (17.3%) and glomerulonephritis (14.8%). In 12%, the diagnosis was uncertain. Major co-morbidities included coronary artery disease (24.7%) chronic lung disease (14.8%), cerebrovascular disease (11.6%) and peripheral vascular disease (8.9%). Non-vascular co-morbidities included arthritis (24.6%), gout (23.6%) and gastro-oesophageal reflux disease (19%). The multi-morbidity profile was differed by gender, diabetic status and age. Over a follow-up period upto 72 months, 93 (8.8%) started RRT and 175 (16.6%) died. Of those 82% died without RRT and 18% died after RRT. Conclusion: This CKD Registry cohort from regional Queensland consisted mainly of older Caucasians with male predominance. A&TSI patients were overrepresented compared to the overall population. A significant proportion had cardio-vascular disease and multiple co-morbidities which differed by gender, diabetic status and age. This report provides valuable data for health services planning and delivery in regional Queensland.
MeSH term(s)	Age Factors ; Aged ; Comorbidity ; Diabetes Mellitus/epidemiology ; Disease Progression ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension/epidemiology ; Male ; Middle Aged ; Patient Care Planning/organization & administration ; Queensland/epidemiology ; Registries/statistics & numerical data ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/etiology ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/therapy ; Risk Factors ; Sex Factors
Language	English
Publishing date	2019-05-02
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1303661-0
ISSN	1440-1797 ; 1320-5358
ISSN (online)	1440-1797
ISSN	1320-5358
DOI	10.1111/nep.13567
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Article ; Online: Chronic Kidney Disease, Queensland (CKD.QLD) Registry: Management of CKD With Telenephrology.

Venuthurupalli, Sree K / Rolfe, Andrea / Fanning, John / Cameron, Anne / Hoy, Wendy E

Kidney international reports

2018 Volume 3, Issue 6, Page(s) 1336–1343

Abstract: Introduction: Enabled by the Chronic Kidney Disease, Queensland (CKD.QLD) Registry, we aim to outline the structure, implementation, and outcomes of telenephrology clinics for the management of patients with chronic kidney disease (CKD) in rural, ... ...

Abstract	Introduction: Enabled by the Chronic Kidney Disease, Queensland (CKD.QLD) Registry, we aim to outline the structure, implementation, and outcomes of telenephrology clinics for the management of patients with chronic kidney disease (CKD) in rural, regional, and remote areas of the Darling Downs region in Queensland, Australia. Methods: This is an observational registry-based study involving adult patients with CKD, attending specialist clinics, and residing ≥50 km away from Toowoomba Hospital. The telenephrology cohort (TC) included those who had their follow-up appointments via videoconference at local Queensland Health facilities, and the standard care cohort (SCC) included those who continue to have their follow-up in Toowoomba Hospital. Results: A total of 234 patients with CKD were seen via videoconference clinics between September 1, 2011 and December 31, 2016, representing 22.2% of the CKD registry cohort from Toowoomba Hospital. The baseline characteristics and comorbid profiles of both groups were similar. The Aboriginal population was overrepresented in the TC (22.2% vs. 5.9%). As a group for each visit, the TC traveled 100,000 km less (both ways) to see a specialist physically. During follow-up, 5.1% of patients in the TC were initiated on dialysis whereas 9.9% were initiated on dialysis in the SCC ( Conclusion: Telenephrology clinics were safe, economical, and efficient for the delivery of specialist care for patients with CKD living at a distance from the main referral hospital. Such care was comparable to standard care delivered at the main hospital but with clear benefits to the patients in terms of reduced travel distance, more independence, and similar outcomes.
Language	English
Publishing date	2018-07-21
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2018.07.013
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Article ; Online: Frequency and Consequences of Acute Kidney Injury in Patients With CKD: A Registry Study in Queensland Australia.

Zhang, Jianzhen / Healy, Helen G / Baboolal, Keshwar / Wang, Zaimin / Venuthurupalli, Sree K / Tan, Ken-Soon / Cameron, Anne / Hoy, Wendy E

Kidney medicine

2019 Volume 1, Issue 4, Page(s) 180–190

Abstract: Background: Acute kidney injury (AKI) contributes to and complicates chronic kidney disease (CKD). We describe AKI documented in hospital encounters in patients with CKD from the CKD Queensland registry.: Study design: A retrospective cohort study ... ...

Abstract	Background: Acute kidney injury (AKI) contributes to and complicates chronic kidney disease (CKD). We describe AKI documented in hospital encounters in patients with CKD from the CKD Queensland registry. Study design: A retrospective cohort study during 2011 to 2016. Setting & participants: Participants had been admitted to a hospital in Queensland. Predictors: AKI was identified from Outcomes: All-cause mortality with or without kidney replacement therapy (KRT), start-up KRT and maintenance KRT, costs of care. Analytical approach: Time to outcomes for those with versus without AKI was evaluated using Cox regression models. Mann-Whitney test was used to compare number of admissions, hospitalized days and costs by AKI status. Results: Among 6,365 patients followed up for up to 5.4 years, 2,199 (35%) had 4,711 hospital encounters with an AKI diagnosis. Those with AKI were older (68 vs 64 years old), were more often men (36.7% vs 32.2%; Limitations: These findings may not be generalizable to CKD populations from the general community or in other health care environments. Conclusions: AKI is associated with strikingly increased deaths, increased rates of KRT, and higher hospital costs.
Language	English
Publishing date	2019-07-13
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2019.06.005
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Article ; Online: CKD.QLD: establishment of a chronic kidney disease [CKD] registry in Queensland, Australia.

Venuthurupalli, Sree K / Hoy, Wendy E / Healy, Helen G / Cameron, Anne / Fassett, Robert G

BMC nephrology

2017 Volume 18, Issue 1, Page(s) 189

Abstract: Background: Chronic kidney disease [CKD] is recognised as a global public health problem. Until recently, the majority of information informing on CKD has been generated from renal registries reporting on patients with end-stage kidney disease [ESKD] ... ...

Abstract	Background: Chronic kidney disease [CKD] is recognised as a global public health problem. Until recently, the majority of information informing on CKD has been generated from renal registries reporting on patients with end-stage kidney disease [ESKD] and on renal replacement therapy [RRT]. There has been a paucity of information on pre-dialysis CKD cohorts, and many issues related to these poorly described populations are unresolved. To this end, international organizations have called for CKD surveillance systems across all countries. Description: In Australia, we have responded by developing the Chronic Kidney Disease in Queensland [CKD.QLD] with three main platforms consisting of CKD Registry, clinical trials and development of biobank. This registry which is the core component of CKD surveillance was conceptualized specifically for the pre-dialysis population in the public health system in Queensland, Australia. Recruitment started in May 2011, and to date the Registry has evolved as one of the largest CKD cohorts in the world with recruitment close to 7000 patients. The Registry has had many outcomes, including being the nidus for Australia's first National Health and Medical Research Council [NHMRC] CKD Centre of Research Excellence [CKD.CRE]. Conclusions: The Registry, with its linkage to Queensland Health datasets, is reporting, and is expected to continue generating, significant information on multiple aspects of CKD, its trajectory, management and patient outcomes. Intent of the CKD.CRE is to facilitate an expanded Registry network that has representation from health services, both public and private, across Australia.
Language	English
Publishing date	2017-06-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-017-0607-5
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Article ; Online: CKD Screening and Surveillance in Australia: Past, Present, and Future.

Venuthurupalli, Sree K / Hoy, Wendy E / Healy, Helen G / Cameron, Anne / Fassett, Robert G

Kidney international reports

2017 Volume 3, Issue 1, Page(s) 36–46

Abstract: Chronic kidney disease (CKD) was largely a hidden health problem until the publication of an internationally agreed approach to its identification, monitoring, and treatment. The 2002 National Kidney Foundation CKD classification and the subsequent 2006 ... ...

Abstract	Chronic kidney disease (CKD) was largely a hidden health problem until the publication of an internationally agreed approach to its identification, monitoring, and treatment. The 2002 National Kidney Foundation CKD classification and the subsequent 2006 Kidney Disease Improving Global Outcomes (KDIGO) recommendations are powerful tools for translating thinking about CKD into clinical practice. These guidelines were strongly endorsed by the international community, including Australia, and were incorporated into CKD practice guidelines. In the past, CKD research studies in Australia focused on screening the general population, and more specifically, individuals at risk for CKD. Information from these studies led to the recognition that the CKD burden in Australia is a public health problem and contributed to the development of national health policies and priorities. At present, apart from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) that reports on CKD patients undergoing renal replacement therapy (RRT), long-term surveillance to describe the natural history of the CKD population not on RRT has only recently started. Entities such as CKD. Queensland and the Western Australian Nephrology Database are able to fill the gap and provide opportunities for collaborative research of CKD in Australia. Establishment of a National Health and Medical Research Centre-funded CKD Centre of Excellence in 2015 and the Better Evidence and Translation-Chronic Kidney Disease in 2016 are likely to change the future of CKD surveillance and research in Australia.
Language	English
Publishing date	2017-10-06
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2017.09.012
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Article ; Online: BMI and its association with death and the initiation of renal replacement therapy (RRT) in a cohort of patients with chronic kidney disease (CKD).

Wang, Zaimin / Zhang, Jianzhen / Chan, Samuel / Cameron, Anne / Healy, Helen G / Venuthurupalli, Sree K / Tan, Ken-Soon / Hoy, Wendy E

BMC nephrology

2019 Volume 20, Issue 1, Page(s) 329

Abstract: Background: A survival advantage associated with obesity has often been described in dialysis patients. The association of higher body mass index (BMI) with mortality and renal replacement therapy (RRT) in preterminal chronic kidney disease (CKD) ... ...

Abstract	Background: A survival advantage associated with obesity has often been described in dialysis patients. The association of higher body mass index (BMI) with mortality and renal replacement therapy (RRT) in preterminal chronic kidney disease (CKD) patients has not been established. Methods: Subjects were patients with pre-terminal CKD who were recruited to the CKD.QLD registry. BMI at time of consent was grouped as normal (BMI 18.5-24.9 kg/m Results: The cohort consisted of 3344 CKD patients, of whom 1777 were males (53.1%). The percentages who had normal BMI, or were overweight, mildly obese and moderately obese+ were 18.9, 29.9, 25.1 and 26.1%, respectively. Using people with normal BMI as the reference group, and after adjusting for age, socio-economic status, CKD stage, primary renal diagnoses, comorbidities including cancer, diabetes, peripheral vascular disease (PVD), chronic lung disease, coronary artery disease (CAD), and all other cardiovascular disease (CVD), the hazard ratios (HRs, 95% CI) of males for death without RRT were 0.65 (0.45-0.92, p = 0.016), 0.60 (0.40-0.90, p = 0.013), and 0.77 (0.50-1.19, p = 0.239) for the overweight, mildly obese and moderately obese+. With the same adjustments the hazard ratios for death without RRT in females were 0.96 (0.62-1.50, p = 0.864), 0.94 (0.59-1.49, p = 0.792) and 0.96 (0.60-1.53, p = 0.865) respectively. In males, with normal BMI as the reference group, the adjusted HRs of starting RRT were 1.15 (0.71-1.86, p = 0.579), 0.99 (0.59-1.66, p = 0.970), and 0.95 (0.56-1.61, p = 0.858) for the overweight, mildly obese and moderately obese+ groups, respectively, and in females they were 0.88 (0.44-1.76, p = 0.727), 0.94 (0.47-1.88, p = 0.862) and 0.65 (0.33-1.29, p = 0.219) respectively. Conclusions: More than 80% of these CKD patients were overweight or obese. Higher BMI seemed to be a significant "protective" factor against death without RRT in males but there was not a significant relationship in females. Higher BMI was not a risk factor for predicting RRT in either male or female patients with CKD.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Body Mass Index ; Cause of Death ; Cohort Studies ; Comorbidity ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/classification ; Kidney Failure, Chronic/mortality ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Obesity/epidemiology ; Obesity/mortality ; Overweight/epidemiology ; Overweight/mortality ; Proportional Hazards Models ; Queensland/epidemiology ; Registries ; Renal Replacement Therapy/statistics & numerical data ; Sex Factors ; Survival Analysis ; Young Adult
Language	English
Publishing date	2019-08-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-019-1513-9
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Article ; Online: Body mass index in an Australian population with chronic kidney disease.

Chan, Samuel / Cameron, Anne / Wang, Zaimin / Venuthurupalli, Sree K / Tan, Ken S / Healy, Helen G / Hoy, Wendy E

BMC nephrology

2018 Volume 19, Issue 1, Page(s) 209

Abstract: Background: Obesity emerged as the leading global health concern in 2017. Although higher body mass index (BMI) is a health risk in the general population, its implications for chronic kidney disease (CKD) are not entirely clear. Our aim was to compare ... ...

Abstract	Background: Obesity emerged as the leading global health concern in 2017. Although higher body mass index (BMI) is a health risk in the general population, its implications for chronic kidney disease (CKD) are not entirely clear. Our aim was to compare BMI in an Australian CKD population with BMI in a sample of the general Australian population, and, in the same group of CKD patients, to describe associations of higher BMI categories with demographic and clinical features. Methods: A cross-sectional study of BMI in CKD patients was conducted from three major sites who were enrolled in the CKD.QLD registry between May 2011 and July 2015. BMI was categorized according to the World Health Organisation (WHO) guidelines. The prevalence of obesity was compared with a sample of the general Australian population from the most recent National Health Survey (NHS). Associations of BMI with demographic and clinical characteristics of the CKD patients were also analysed. Results: There were 3382 CKD patients in this study (median age 68, IQR 56-76 years); 50.5% had BMI ≥30, the WHO threshold for obesity, in contrast with 28.4% having BMI ≥30 in the NHS cohort. Higher BMI categories were correlated with age < 70 years, male gender, and lower socioeconomic status. After adjustment for age and gender, characteristics which significantly correlated with higher BMI category included hypertension, dyslipidemia, diabetes, diabetic nephropathy, coronary heart disease, other cardiovascular diseases, gout, obstructive sleep apnoea, depression and chronic lung disease. Conclusions: Patients with CKD in public renal specialty practices in Queensland have strikingly higher rates of obesity than the general Australian population. Within the CKD population, low socio-economic position strongly predisposes to higher BMI categories. Higher BMI categories also strongly correlated with important co-morbidities that contribute to burden of illness. These data flag major opportunities for primary prevention of CKD and for reductions in morbidity in people who already have CKD, which should be considered in public health policy in relation to obesity.
MeSH term(s)	Aged ; Aged, 80 and over ; Australia/epidemiology ; Body Mass Index ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity/diagnosis ; Obesity/epidemiology ; Population Surveillance/methods ; Registries ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology
Language	English
Publishing date	2018-08-20
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2041348-8
ISSN	1471-2369 ; 1471-2369
ISSN (online)	1471-2369
ISSN	1471-2369
DOI	10.1186/s12882-018-1006-2
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Article ; Online: Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia.

Diwan, Vishal / Hoy, Wendy E / Wang, Zaimin / Zhang, Jianzhen / Cameron, Anne / Venuthurupalli, Sree K / Fassett, Robert G / Chan, Samuel / Healy, Helen G / Tan, Ken-Soon / Baer, Richard / Mallett, Andrew J / Gray, Nicholas / Mantha, Murty / Cherian, Roy / Mutatiri, Clyson / Madhan, Krishan / Kan, George / Mitchell, Geoffrey /

Hossain, Shahadat / Wu, Danielle / Han, Thin / Kark, Adrian / Titus, Thomas / Ranganathan, Dwarakanatan / Bonner, Ann / Govindarajulu, Sridevi

Kidney medicine

2023 Volume 5, Issue 9, Page(s) 100700

Abstract: Rationale & objective: Little is known about hospital admissions in nondialysis patients with chronic kidney disease (CKD) before death or starting kidney replacement therapy (KRT).: Study design: Retrospective observational cohort study.: Setting & ...

Abstract	Rationale & objective: Little is known about hospital admissions in nondialysis patients with chronic kidney disease (CKD) before death or starting kidney replacement therapy (KRT). Study design: Retrospective observational cohort study. Setting & participants: Hospitalizations among 7,201 patients with CKD from 10 public renal clinics in Queensland (QLD), enrolled in the CKD.QLD registry starting in May 2011, were followed for 25,496.34 person-years until they started receiving KRT or died, or until June 30, 2018. Predictors: Demographic and clinical characteristics of patients with CKD. Outcomes: Hospital admissions. Analytical approach: We evaluated the association of demographic and clinical features with hospitalizations, length of hospital stay, and cost. Results: Approximately 81.5% of the patients were admitted at least once, with 42,283 admissions, costing Australian dollars (AUD) 231 million. The average number of admissions per person-year was 1.7, and the cost was AUD 9,060, 10 times and 2 times their Australian averages, respectively. Single (1-day) admissions constituted 59.2% of all the hospital episodes, led by neoplasms (largely chemotherapy), anemia, CKD-related conditions and eye conditions (largely cataract extractions), but only 14.8% of the total costs. Approximately 41% of admissions were >1-day admissions, constituting 85.2% of the total costs, with cardiovascular conditions, respiratory conditions, CKD-related conditions, and injuries, fractures, or poisoning being the dominant causes. Readmission within 30 days of discharge constituted >42% of the admissions and 46.8% costs. Admissions not directly related to CKD constituted 90% of the admissions and costs. More than 40% of the admissions and costs were through the emergency department. Approximately 19% of the hospitalized patients and 27% of the admissions did not have kidney disease mentioned as either principal or associate causes. Limitations: Variable follow-up times because of different dates of consent. Conclusions: The hospital burden of patients with CKD is mainly driven by complex multiday admissions and readmissions involving comorbid conditions, which may not be directly related to their CKD. Strategies to prevent these complex admissions and readmissions should minimize hospital costs and outcomes. Plain-language summary: We analyzed primary causes, types, and costs of hospitalizations among 7,201 patients with chronic kidney disease (CKD) from renal speciality clinics across Queensland, Australia, over an average follow-up of 3.54 years. The average annual cost per person was $9,060, and was the highest in those with more advanced CKD, higher age, and with diabetes. More than 85% of costs were driven by more complex hospitalizations with longer length of stay. Cardiovascular disease was the single largest contributor for hospitalizations, length of hospital stay, and total costs. Readmission within 30 days of discharge, particularly for the same disorder, and multiday admissions should be the main targets for mitigation of hospital costs in this population.
Language	English
Publishing date	2023-07-26
Publishing country	United States
Document type	Journal Article
ISSN	2590-0595
ISSN (online)	2590-0595
DOI	10.1016/j.xkme.2023.100700
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Article ; Online: Chronic kidney disease in public renal practices in Queensland, Australia, 2011-2018.

Hoy, Wendy E / Wang, Zaimin / Zhang, Jianzhen / Diwan, Vishal / Cameron, Anne / Venuthurupalli, Sree K / Fassett, Robert G / Chan, Samuel / Healy, Helen G / Tan, Ken-Soon / Baer, Richard / Mallett, Andrew J / Gray, Nicholas / Mantha, Murty / Cherian, Roy / Mutatiri, Clyson / Madhan, Krishan / Kan, George / Mitchell, Geoffrey /

Hossain, Shahadat / Wu, Danielle / Han, Thin / Kark, Adrian / Titus, Thomas / Ranganathan, Dwarakanatan / Bonner, Ann / Govindarajulu, Sridevi

Nephrology (Carlton, Vic.)

2022 Volume 27, Issue 12, Page(s) 934–944

Abstract: Aim: To describe adults with (non-dialysis) chronic kidney disease (CKD) in nine public renal practice sites in the Australian state of Queensland.: Methods: 7,060 persons were recruited to a CKD Registry in May 2011 and until start of kidney ... ...

Abstract	Aim: To describe adults with (non-dialysis) chronic kidney disease (CKD) in nine public renal practice sites in the Australian state of Queensland. Methods: 7,060 persons were recruited to a CKD Registry in May 2011 and until start of kidney replacement therapy (KRT), death without KRT or June 2018, for a median period of 3.4 years. Results: The cohort comprised 7,060 persons, 52% males, with a median age of 68 yr; 85% had CKD stages 3A to 5, 45.4% were diabetic, 24.6% had diabetic nephropathy, and 51.7% were obese. Younger persons mostly had glomerulonephritis or genetic renal disease, while older persons mostly had diabetic nephropathy, renovascular disease and multiple diagnoses. Proportions of specific renal diagnoses varied >2-fold across sites. Over the first year, eGFR fell in 24% but was stable or improved in 76%. Over follow up, 10% started KRT, at a median age of 62 yr, most with CKD stages 4 and 5 at consent, while 18.8% died without KRT, at a median age of 80 yr. Indigenous people were younger at consent and more often had diabetes and diabetic kidney disease and had higher incidence rates of KRT. Conclusion: The spectrum of characteristics in CKD patients in renal practices is much broader than represented by the minority who ultimately start KRT. Variation in CKD by causes, age, site and Indigenous status, the prevalence of obesity, relative stability of kidney function in many persons over the short term, and differences between those who KRT and die without KRT are all important to explore.
MeSH term(s)	Adult ; Male ; Humans ; Aged ; Aged, 80 and over ; Female ; Queensland/epidemiology ; Renal Dialysis ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/epidemiology ; Diabetic Nephropathies/therapy ; Australia ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/therapy ; Obesity/diagnosis ; Obesity/epidemiology ; Kidney
Language	English
Publishing date	2022-10-09
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1303661-0
ISSN	1440-1797 ; 1320-5358
ISSN (online)	1440-1797
ISSN	1320-5358
DOI	10.1111/nep.14111
Database	MEDical Literature Analysis and Retrieval System OnLINE

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