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Factors associated with chronic kidney disease progression in Australian nephrology practices

journal contribution
posted on 2023-05-17, 18:20 authored by Boudville, N, Kemp, A, Moody, H, Fassett, RG, Pedagogos, E, Nelson, C, Healy, H, Mangos, G, Kirkland, G, Kay, T, Champion De Crespigny, P, Hoffman, D, Waugh, D

Background/Aims: Chronic kidney disease (CKD) is a major health issue worldwide. The aim of this study was to explore factors associated with CKD progression in Australian nephrology practices.

Methods: This was a retrospective study utilising an electronic medical record (EMR), Audit4 (Software for Specialists, Australia). The baseline visit was defined as the first entry into the EMR. The primary outcome was the rate of change in estimated glomerular filtration rate (eGFR).

Results: 1,328 patients were included with a mean eGFR at baseline of 37.4 ± 0.7 ml/min/1.73 m2, a mean follow-up of 17.7 months and a mean annual rate of change in eGFR of -0.84 ± 0.26 ml/min/1.73 m2. Univariate analysis demonstrated that women, smokers, and patients prescribed erythropoiesis-stimulating agents (ESA) had a significantly more rapid decline in eGFR (p = 0.007, 0.033, and 0.003, respectively). On multivariate analysis: gender, age, prescription of ESA and phosphate binders, and baseline eGFR were significantly associated with CKD progression (p = 0.003, 0.004, <0.001, 0.029, and <0.001, respectively).

Conclusions: This study identifies potential factors associated with CKD progression in a population referred to nephrologists, but current data quality may result in bias. Implementation of changes in the format of data collection is required so that busy clinicians record essential information to enable this to become a more accurate and reliable research tool.

History

Publication title

Nephron - Clinical Practice

Volume

121

Issue

1-2

Pagination

c36-c41

ISSN

1660-2110

Department/School

Tasmanian School of Medicine

Publisher

Karger

Place of publication

Allschwilerstrasse 10, Basel, Switzerland, Ch-4009

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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