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Cross-sectional observation study to investigate the impact of risk-based stratification on care pathways for patients with chronic kidney disease: protocol paper
- Source :
- BMJ Open, Vol 9, Iss 6 (2019), BMJ Open
- Publication Year :
- 2019
- Publisher :
- BMJ Publishing Group, 2019.
-
Abstract
- IntroductionChronic kidney disease (CKD) management in the UK is usually primary care based, with National Institute for Health and Care Excellence (NICE) guidelines defining criteria for referral to secondary care nephrology services. Estimated glomerular filtration rate (eGFR) is commonly used to guide timing of referrals and preparation of patients approaching renal replacement therapy. However, eGFR lacks sensitivity for progression to end-stage renal failure; as a consequence, the international guideline group, Kidney Disease: Improving Global Outcomes has recommended the use of a risk calculator. The validated Kidney Failure Risk Equation may enable increased precision for the management of patients with CKD; however, there is little evidence to date for the implication of its use in routine clinical practice. This study will aim to determine the impact of the Kidney Failure Risk Equation on the redesignation of patients with CKD in the UK for referral to secondary care, compared with NICE CKD guidance.Method and analysisThis is a cross-sectional population-based observational study using The Health Improvement Network database to identify the impact of risk-based designation for referral into secondary care for patients with CKD in the UK. Adult patients registered in primary care and active in the database within the period 1 January 2016 to 31 March 2017 with confirmed CKD will be analysed. The proportion of patients who meet defined risk thresholds will be cross-referenced with the current NICE guideline recommendations for referral into secondary care along with an evaluation of urinary albumin–creatinine ratio monitoring.Ethics and disseminationApproval was granted by The Health Improvement Network Scientific Review Committee (Reference number: 18THIN061). Study outcomes will inform national and international guidelines including the next version of the NICE CKD guideline. Dissemination of findings will also be through publication in a peer-reviewed journal, presentation at conferences and inclusion in the core resources of the Think Kidneys programme.
- Subjects :
- Male
Nephrology
medicine.medical_treatment
030232 urology & nephrology
Nice
0302 clinical medicine
Risk Factors
Protocol
030212 general & internal medicine
computer.programming_language
education.field_of_study
Renal Medicine
General Medicine
Middle Aged
Prognosis
Creatinine
Population Surveillance
Disease Progression
Medicine
Female
Glomerular Filtration Rate
Adult
medicine.medical_specialty
Referral
Population
end stage renal failure
Risk Assessment
Secondary Care
Young Adult
03 medical and health sciences
chronic renal failure
Internal medicine
medicine
Humans
Renal replacement therapy
Renal Insufficiency, Chronic
education
Intensive care medicine
Aged
Retrospective Studies
business.industry
Guideline
medicine.disease
United Kingdom
Cross-Sectional Studies
Observational study
Morbidity
business
computer
Biomarkers
Follow-Up Studies
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 20446055
- Volume :
- 9
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....0d69856835302993270ffa3470360b88