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Br J Gen Pract. 2010 Dec;60(581):884-90. doi: 10.3399/bjgp10X544041.

Chronic kidney disease in patients with diabetes mellitus type 2 or hypertension in general practice.

Author information

1
Department of Public Health and Primary Care, Leiden University Medical Centre and Academic Primary Health Care Centre 'Stevenshof', Leiden, The Netherlands. v.van_der_meer@lumc.nl

Abstract

BACKGROUND:

The prevalence and severity of chronic kidney disease (CKD) in primary care patients with diabetes or hypertension is unknown.

AIM:

To assess the prevalence and severity of CKD in patients with diabetes and hypertension; and identify whether age, sex, diabetes, and hypertension are associated with CKD.

DESIGN OF STUDY:

Cross-sectional survey.

SETTING:

Two Dutch primary health care centres (15 954 enlisted patients).

METHOD:

Patients, aged ≥ 25 years, with known diabetes type 2 (n = 471) or hypertension (n = 960), were selected on 1 October 2006. Initial screening uptake rates were assessed from the electronic patient records, and patients were invited when blood or urine measurements were missing. The presence of albuminuria was determined, glomerular filtration rate estimated, and clinical characteristics extracted.

RESULTS:

Initial screening uptake rates were 93% and 69% for diabetes and hypertension, respectively, and increased to 97% (n = 455) and 87% (n = 836) after active invitation. The prevalence of CKD was 28% in diabetes and 21% in hypertension only. The presence of diabetes was independently associated with albuminuria (odds ratio [OR] 4.23; 95% confidence interval [CI] = 2.67 to 6.71), but not with decreased estimated GFR (eGFR) (OR 0.75; 95% CI = 0.54 to 1.04). Age showed the strongest association with decreased eGFR (OR 2.73; 95% CI = 2.02 to 3.70).

CONCLUSION:

In primary care, more than one-quarter of patients with diabetes and about one-fifth of patients with hypertension have CKD. The high prevalence justifies longitudinal follow-up in order to evaluate whether intensified cardiovascular risk management is beneficial in this primary care population.

PMID:
21144198
PMCID:
PMC2991741
DOI:
10.3399/bjgp10X544041
[Indexed for MEDLINE]
Free PMC Article
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