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Title: Can routinely collected primary care data determine the prevalence of chronic kidney disease and predict clinical events in patients with stages 3 of the disease?
Author: Jain, Poorva
ISNI:       0000 0004 5350 5221
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2015
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Introduction Chronic Kidney Disease (CKD) is common and associated with cardiovascular morbidity and mortality. Few studies have assessed the real prevalence of CKD and the predictors of morbidity and mortality in this cohort. Methods Using THIN data, the prevalence of CKD 1-5 was ascertained .This was compared to the prevalence on the practice register using QOF Read codes in 2009. Cox proportional hazard models using routinely collected primary care were used identify predictors of i) all-cause mortality and ii) the composite of cardiovascular disease and all-cause mortality. Results The prevalence of CKD 1-5 was 5.01%. Patients with CKD not on the practice register were associated with worse management than those on the practice register. Increasing age and co-morbidity were associated with worse outcomes. Continuous variables such as hypertension, BMI, haemoglobin and cholesterol were associated with an inverse J shaped relationship with log relative hazard ratio. Antihypertensives and lipid lowering drug usage, and non white ethnicity was associated with improved outcomes. Blood thinning agents and diuretics were associated with worse outcomes. Conclusions CKD is common in UK. Many practices mis-label CKD which impacts upon management. Some predictors of mortality and morbidity is different to previous reports and this requires further investigation.
Supervisor: Not available Sponsor: National Institute of Health Research
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC Internal medicine