Roberto Pecoits-Filho, Kean-Seng Lim, Maria Cristina Ribeiro de Castro, Ana Cebrian, Rafael Santamaria, Naresh Kanumilli, Christian S. Alvarez, Matthew Arnold, Salvatore Barone, Hungta Chen, Krister Järbrink, Navdeep Tangri
{"title":"澳大利亚、巴西、加拿大、英国和西班牙未记录的3期慢性肾脏疾病的高患病率：多国观察性REVEAL-CKD研究","authors":"Roberto Pecoits-Filho, Kean-Seng Lim, Maria Cristina Ribeiro de Castro, Ana Cebrian, Rafael Santamaria, Naresh Kanumilli, Christian S. Alvarez, Matthew Arnold, Salvatore Barone, Hungta Chen, Krister Järbrink, Navdeep Tangri","doi":"10.1155/ijcp/5138534","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> Chronic kidney disease (CKD) is a global public health concern, affecting approximately 850 million people worldwide. Guidelines recommend early identification and management of CKD to mitigate disease progression and delay the onset of complications. Recording a CKD diagnosis in medical records is associated with improved kidney function and blood pressure monitoring, better use of disease-modifying therapy, and reduced risk of CKD progression. REVEAL-CKD is a multinational, observational study that aims to estimate the prevalence of stage 3 CKD which is unrecorded in administrative databases.</p>\n <p><b>Methods:</b> Data were extracted from country-specific databases of patient medical records in Australia, Brazil, Canada, England, and Spain. Included patients (aged ≥ 18 years) had two consecutive estimated glomerular filtration rate (eGFR) measurements between 30 and < 60 mL/min/1.73 m<sup>2</sup> taken 91–730 days apart. Patients were considered to have unrecorded CKD if they had no CKD diagnosis code (any stage) at any time before and up to 6 months after study index (date of second qualifying eGFR).</p>\n <p><b>Results:</b> Across countries, median age was 72–78 years, median eGFR was 46.5–53.5 mL/min/1.73 m<sup>2</sup>, and availability of urinary albumin—creatinine ratio testing ranged from 4.9% (Brazil) to 53.5% (Canada). The prevalence of unrecorded stage 3 CKD was 90.0% (1002/1113 patients) in Australia, 97.0% (10,925/11,262) in Brazil, 92.0% (42,226/45,914) in Canada, 56.9% (84,237/148,153 in England, and 84.8% (27,035/31,866) in Spain.</p>\n <p><b>Conclusions:</b> More than half of the patients with laboratory evidence of stage 3 CKD lacked a CKD diagnosis code in all countries examined. Substantial intercountry variations in rates of CKD recording and testing were observed. International sharing of best practice guidance, systematic changes to improve data quality, and increased awareness of the importance of timely coding among healthcare professionals will help to improve accurate recording of stage 3 CKD.</p>\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04847531.</p>\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2024 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5138534","citationCount":"0","resultStr":"{\"title\":\"High Prevalence of Unrecorded Stage 3 Chronic Kidney Disease in Australia, Brazil, Canada, England, and Spain: The Multinational, Observational REVEAL-CKD Study\",\"authors\":\"Roberto Pecoits-Filho, Kean-Seng Lim, Maria Cristina Ribeiro de Castro, Ana Cebrian, Rafael Santamaria, Naresh Kanumilli, Christian S. Alvarez, Matthew Arnold, Salvatore Barone, Hungta Chen, Krister Järbrink, Navdeep Tangri\",\"doi\":\"10.1155/ijcp/5138534\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> Chronic kidney disease (CKD) is a global public health concern, affecting approximately 850 million people worldwide. Guidelines recommend early identification and management of CKD to mitigate disease progression and delay the onset of complications. Recording a CKD diagnosis in medical records is associated with improved kidney function and blood pressure monitoring, better use of disease-modifying therapy, and reduced risk of CKD progression. REVEAL-CKD is a multinational, observational study that aims to estimate the prevalence of stage 3 CKD which is unrecorded in administrative databases.</p>\\n <p><b>Methods:</b> Data were extracted from country-specific databases of patient medical records in Australia, Brazil, Canada, England, and Spain. Included patients (aged ≥ 18 years) had two consecutive estimated glomerular filtration rate (eGFR) measurements between 30 and < 60 mL/min/1.73 m<sup>2</sup> taken 91–730 days apart. Patients were considered to have unrecorded CKD if they had no CKD diagnosis code (any stage) at any time before and up to 6 months after study index (date of second qualifying eGFR).</p>\\n <p><b>Results:</b> Across countries, median age was 72–78 years, median eGFR was 46.5–53.5 mL/min/1.73 m<sup>2</sup>, and availability of urinary albumin—creatinine ratio testing ranged from 4.9% (Brazil) to 53.5% (Canada). The prevalence of unrecorded stage 3 CKD was 90.0% (1002/1113 patients) in Australia, 97.0% (10,925/11,262) in Brazil, 92.0% (42,226/45,914) in Canada, 56.9% (84,237/148,153 in England, and 84.8% (27,035/31,866) in Spain.</p>\\n <p><b>Conclusions:</b> More than half of the patients with laboratory evidence of stage 3 CKD lacked a CKD diagnosis code in all countries examined. 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International sharing of best practice guidance, systematic changes to improve data quality, and increased awareness of the importance of timely coding among healthcare professionals will help to improve accurate recording of stage 3 CKD.</p>\\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04847531.</p>\\n </div>\",\"PeriodicalId\":13782,\"journal\":{\"name\":\"International Journal of Clinical Practice\",\"volume\":\"2024 1\",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/5138534\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/5138534\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/5138534","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
High Prevalence of Unrecorded Stage 3 Chronic Kidney Disease in Australia, Brazil, Canada, England, and Spain: The Multinational, Observational REVEAL-CKD Study
Background: Chronic kidney disease (CKD) is a global public health concern, affecting approximately 850 million people worldwide. Guidelines recommend early identification and management of CKD to mitigate disease progression and delay the onset of complications. Recording a CKD diagnosis in medical records is associated with improved kidney function and blood pressure monitoring, better use of disease-modifying therapy, and reduced risk of CKD progression. REVEAL-CKD is a multinational, observational study that aims to estimate the prevalence of stage 3 CKD which is unrecorded in administrative databases.
Methods: Data were extracted from country-specific databases of patient medical records in Australia, Brazil, Canada, England, and Spain. Included patients (aged ≥ 18 years) had two consecutive estimated glomerular filtration rate (eGFR) measurements between 30 and < 60 mL/min/1.73 m2 taken 91–730 days apart. Patients were considered to have unrecorded CKD if they had no CKD diagnosis code (any stage) at any time before and up to 6 months after study index (date of second qualifying eGFR).
Results: Across countries, median age was 72–78 years, median eGFR was 46.5–53.5 mL/min/1.73 m2, and availability of urinary albumin—creatinine ratio testing ranged from 4.9% (Brazil) to 53.5% (Canada). The prevalence of unrecorded stage 3 CKD was 90.0% (1002/1113 patients) in Australia, 97.0% (10,925/11,262) in Brazil, 92.0% (42,226/45,914) in Canada, 56.9% (84,237/148,153 in England, and 84.8% (27,035/31,866) in Spain.
Conclusions: More than half of the patients with laboratory evidence of stage 3 CKD lacked a CKD diagnosis code in all countries examined. Substantial intercountry variations in rates of CKD recording and testing were observed. International sharing of best practice guidance, systematic changes to improve data quality, and increased awareness of the importance of timely coding among healthcare professionals will help to improve accurate recording of stage 3 CKD.
期刊介绍：
IJCP is a general medical journal. IJCP gives special priority to work that has international appeal.
IJCP publishes:
Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion]
Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion]
Study design and interpretation. Example. [Always peer reviewed]
Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed]
Meta-analyses. [Always peer reviewed]
Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed]
Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed]
''How to…'' papers. Example. [Always peer reviewed]
Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed]
Letters. [Peer reviewed at the editor''s discretion]
International scope
IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.
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