Current chronic kidney disease practice patterns in the UK: a national survey

Ahmad, Azhar; Roderick, Paul; Ward, Malcolm; Steenkamp, Retha; Burden, Richard; O’Donoghue, Dónal; Ansell, David; Feest, Terry

doi:10.1093/qjmed/hcl029

Cited by 18 publications

(21 citation statements)

References 15 publications

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“…• surveys/audits (n = 4) surveys/audits of current care provision [135][136][137][138] • evaluation studies (n = 13) evaluating single services or comparing different services [139][140][141][142][143][144][145][146][147][148][149][150][151] • descriptive studies (n = 7) describing single services, groups of services, individual specialties within services or an intervention for care [152][153][154][155][156][157][158] Chapter 5…”

Section: Resultsmentioning

confidence: 99%

“…135 Dieticians and dialysis education providers were common, attending CKD clinics in more than 95% of the renal units. 135 Additionally, 70% of units ran satellite clinics for CKD patients in a general district hospital from where patients could access the full team services. 135 Only two units reported to have shared primary and secondary care schemes.…”

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

“…135 Additionally, 70% of units ran satellite clinics for CKD patients in a general district hospital from where patients could access the full team services. 135 Only two units reported to have shared primary and secondary care schemes. 136 A further six centres were developing SCSs; three were developing nurse-led services where nurse specialists would manage stable patients and/or the initial assessment of new referrals.…”

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

“…Most of the low clearance clinics were run by specialist renal nurses who had various roles including communicating with the staff involved in CKD management, patient education, counselling, transplant assessments, prescribing under medical supervision and reviewing patients. 135 Pre-dialysis education was noted in 16% of the units 136 where dialysis nurses, transplant coordinators, dieticians and pharmacists provided dialysis education to CKD patients. 135 A survey of the organisation of care provided to CKD stage 3-5 patients by nephrology clinics in Italy 139 highlighted important and frequent deviations from guidelines in the centres' policies for caring for CKD patients including: the definition of low eGFR, management of anaemia and bone mineral metabolism, and preparation for dialysis.…”

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

“…135 Pre-dialysis education was noted in 16% of the units 136 where dialysis nurses, transplant coordinators, dieticians and pharmacists provided dialysis education to CKD patients. 135 A survey of the organisation of care provided to CKD stage 3-5 patients by nephrology clinics in Italy 139 highlighted important and frequent deviations from guidelines in the centres' policies for caring for CKD patients including: the definition of low eGFR, management of anaemia and bone mineral metabolism, and preparation for dialysis. A report of a local CKD network established in the UK (membership included: local GPs, consultant nephrologists, consultant nurses, commissioners, a patient representative and representatives from the primary care trusts) described a network approach with supporting referral guidelines and an education programme that had been introduced to support increasing local demand on nephrology services.…”

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

See 4 more Smart Citations

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Black

Sharma²,

Scotland³

et al. 2010

Health Technol Assess

178

144

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects...

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Section: Resultsmentioning

confidence: 99%

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

Section: Overview Of Existing Models Of Care Deliverymentioning

confidence: 99%

See 3 more Smart Citations

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Black

Sharma²,

Scotland³

et al. 2010

Health Technol Assess

178

144

View full text Add to dashboard Cite

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Chronic Kidney Disease and the Risk of Incident Gout Among Middle‐Aged Men: A Seven‐Year Prospective Observational Study

Krishnan

2013

Arthritis & Rheumatism

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Objective. The kidney is the major organ that facilitates excretion of urate in humans. Surprisingly, few studies have assessed whether a reduced glomerular filtration rate (GFR) and/or kidney damage is associated with a higher incidence of gout, and this study was undertaken to address this question.Methods. Data from a 7-year followup of patients enrolled in the Multiple Risk Factor Intervention Trial, a primary prevention trial for cardiovascular disease among 12,866 men ages 35-57 years, were used for the present investigation. Presence of gout was determined by the study physicians from the original trial. Chronic kidney disease was defined using criteria similar to those proposed by the National Kidney Foundation. The Cox proportional hazards regression model was used to assess the association between gout and chronic kidney disease, after accounting for the effects of potential confounders.Results

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Validation of The Health Improvement Network (THIN) database for epidemiologic studies of chronic kidney disease

Denburg

Haynes

Shults

et al. 2011

Pharmacoepidemiology and Drug

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Purpose Chronic kidney disease (CKD) is a prevalent and important outcome and covariate in pharmacoepidemiology. The Health Improvement Network (THIN) in the U.K. represents a unique resource for population-based studies of CKD. We compiled a valid list of Read codes to identify subjects with moderate to advanced CKD. Methods A cross-sectional validation study was performed to identify codes that best define CKD stages 3–5. All subjects with at least one non-zero measure of serum creatinine after 1-Jan-2002 were included. Estimated glomerular filtration rate (eGFR) was calculated according to the Schwartz formula for subjects <18 years and the Modification of Diet in Renal Disease formula for subjects ≥18 years of age. CKD was defined as an eGFR <60 ml/min/1.73m2 on at least two occasions, more than 90 days apart. Results The laboratory definition identified 230,426 subjects with CKD, for a period prevalence in 2008 of 4.56% (95% CI: 4.54, 4.58). A list of 45 Read codes was compiled which yielded a positive predictive value of 88.9% (95% CI: 88.7, 89.1), sensitivity of 48.8%, negative predictive value of 86.5%, and specificity of 98.2%. Of the 11.1% of subjects with a code who did not meet the laboratory definition, 83.6% had at least one eGFR <60. The most commonly used code was for CKD stage 3. Conclusions The proposed list of codes can be used to accurately identify CKD when serum creatinine data are limited. The most sensitive approach for the detection of CKD is to use this list to supplement creatinine measures.

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Current chronic kidney disease practice patterns in the UK: a national survey

Abstract: CKD patients are a significant workload for UK nephrologists. Current provision of service is variable, and services need to be re-designed to cope with the expected future increase of referral of CKD patients.

Cited by 18 publications

References 15 publications

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis

Chronic Kidney Disease and the Risk of Incident Gout Among Middle‐Aged Men: A Seven‐Year Prospective Observational Study

Validation of The Health Improvement Network (THIN) database for epidemiologic studies of chronic kidney disease

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