The association between coding for chronic kidney disease and kidney replacement therapy incidence at CCG-level in England: an ecological study.

IF 2.5 Q2 PRIMARY HEALTH CARE
BJGP Open Pub Date : 2025-02-07 DOI:10.3399/BJGPO.2024.0171
Christoph Heinrich Lindemann, James Medcalf, James Fv Hollinshead, Dorothea Nitsch
{"title":"The association between coding for chronic kidney disease and kidney replacement therapy incidence at CCG-level in England: an ecological study.","authors":"Christoph Heinrich Lindemann, James Medcalf, James Fv Hollinshead, Dorothea Nitsch","doi":"10.3399/BJGPO.2024.0171","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>With ageing of the population both prevalence of chronic kidney disease (CKD) and incidence of kidney replacement therapy (KRT) are rising. Existing research suggests that Read-coding for CKD in those affected is associated with better implementation of recommended care and fewer hospitalisations for heart failure.</p><p><strong>Aim: </strong>To investigate whether coding for CKD is associated with regional KRT incidence in England.</p><p><strong>Design & setting: </strong>This is an ecological study using the clinical commissioning groups (CCG) in England as geographical units.</p><p><strong>Method: </strong>KRT incidence rates were calculated using UK Renal Registry (UKRR) data from 01/2019 to 12/2021. Data on the percentage of uncoded CKD patients (PUCP) who had laboratory evidence of CKD but lacked a diagnostic code were obtained from the CVDPREVENT Audit, a national audit that extracts routinely held general practitioner data. Data on confounders and acute kidney injury (AKI) mortality as a marker for population frailty were obtained from CVDPREVENT and the UKRR, respectively. Poisson models assessed the association between PUCP and KRT incidence.</p><p><strong>Results: </strong>After adjusting, the PUCP was non-linearly associated with KRT incidence, with the CCGs in the lowest PUCP quintile having a lower KRT incidence than the others. There was evidence that this association was more pronounced in CCGs with high AKI mortality compared to CCGs with low AKI mortality.</p><p><strong>Conclusion: </strong>At the geographical level in England, the data suggests that the prevalence of not having formally diagnosed CKD is non-linearly associated with a higher KRT incidence rate, especially in areas with a high AKI mortality.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJGP Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3399/BJGPO.2024.0171","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0

Abstract

Background: With ageing of the population both prevalence of chronic kidney disease (CKD) and incidence of kidney replacement therapy (KRT) are rising. Existing research suggests that Read-coding for CKD in those affected is associated with better implementation of recommended care and fewer hospitalisations for heart failure.

Aim: To investigate whether coding for CKD is associated with regional KRT incidence in England.

Design & setting: This is an ecological study using the clinical commissioning groups (CCG) in England as geographical units.

Method: KRT incidence rates were calculated using UK Renal Registry (UKRR) data from 01/2019 to 12/2021. Data on the percentage of uncoded CKD patients (PUCP) who had laboratory evidence of CKD but lacked a diagnostic code were obtained from the CVDPREVENT Audit, a national audit that extracts routinely held general practitioner data. Data on confounders and acute kidney injury (AKI) mortality as a marker for population frailty were obtained from CVDPREVENT and the UKRR, respectively. Poisson models assessed the association between PUCP and KRT incidence.

Results: After adjusting, the PUCP was non-linearly associated with KRT incidence, with the CCGs in the lowest PUCP quintile having a lower KRT incidence than the others. There was evidence that this association was more pronounced in CCGs with high AKI mortality compared to CCGs with low AKI mortality.

Conclusion: At the geographical level in England, the data suggests that the prevalence of not having formally diagnosed CKD is non-linearly associated with a higher KRT incidence rate, especially in areas with a high AKI mortality.

求助全文
约1分钟内获得全文 求助全文
来源期刊
BJGP Open
BJGP Open Medicine-Family Practice
CiteScore
5.00
自引率
0.00%
发文量
181
审稿时长
22 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信