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Title: The epidemiology of chronic kidney disease in Grampian
Author: Clark, Laura Elizabeth
ISNI:       0000 0004 2682 4956
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2009
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Methods: All patients (5606) with at least one serum creatinine ≥130μmol/L in females and ≥150μmol/L (Index creatinine) in males during a 6 month period in 2003 were grouped according to whether they had Acute Kidney Injury (AKI), Acute on chronic renal failure (ACRF) and chronic kidney disease (CKD). 1903 patients could  not be classified. After using all available creatinine data and identifying markers of kidney damage a further group of patients with CKD were identified. Case records were examined for the presence of co-morbidity, date of death, cause of death and whether they were known to a renal physician. Results: 1225 patients were identified as having CKD out of the 1903 “Unclassified” cohort (65%). The majority of CKD patients were elderly females with Stage 3 CKD. Hypertension and ischaemic heart disease were the two most common co-morbid conditions. Only 12% of CKD patients were referred to a nephrologists. 43% of CKD patients were dead at follow-up mostly from cardiovascular causes (31st December 2005). The presence of proteinuria was independently associated with death. The age adjusted standardised prevalence of CKD, excluding those on RRT, was 20929 per million adult population. 3.6% went on to start RRT by the end of follow-up. Conclusions: CKD is predominantly a condition of elderly females, associated with considerable morbidity and mortality. However the majority of patients die from cardiovascular disease before progressing to ESRD. Therefore these patients may be appropriately managed in primary care without the need for specialist renal input allowing targeting of the specialist renal resources to the fewer patients who require them.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Kidney Diseases ; Kidney Failure, Chronic