RT Journal Article
SR Electronic
T1 Chronic kidney disease in patients with diabetes mellitus type 2 or hypertension in general practice
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 884
OP 890
DO 10.3399/bjgp10X544041
VO 60
IS 581
A1 Victor van der Meer
A1 H Petra M Wielders
A1 Diana C Grootendorst
A1 Joost S de Kanter
A1 Yvo WJ Sijpkens
A1 Willem JJ Assendelft
A1 Jacobijn Gussekloo
A1 Friedo W Dekker
A1 Ymte Groeneveld
YR 2010
UL http://bjgp.org/content/60/581/884.abstract
AB 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.