Screening and diagnosis of chronic kidney disease in people with type 2 diabetes attending Australian general practice

2018 ◽  
Vol 24 (3) ◽  
pp. 280 ◽  
Author(s):  
Jo-Anne E. Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Phyllis Lau ◽  
Irene Blackberry ◽  
Janet K. Sluggett ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
General Practice ◽  
Kidney Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Barriers To Screening ◽  
Australian General Practice ◽  
Recorded Diagnosis

Australian guidelines recommend annual screening and monitoring of chronic kidney disease (CKD) in people with type 2 diabetes (T2D). A cross-sectional study utilising data from NPS MedicineWise MedicineInsight program from June 2015 to May 2016 was undertaken to explore: (1) the proportion of patients with T2D attending general practice who have had screening for, or ongoing monitoring of, CKD; (2) the proportion of patients without a documented diagnosis of CKD who have pathology consistent with CKD diagnosis; and (3) the patient factors associated with screening and the recording of a diagnosis of CKD. Of 90550 patients with T2D, 44394 (49.0%) were appropriately screened or monitored. There were 8030 (8.9%) patients with a recorded diagnosis of CKD, whereas 6597 (7.3%) patients had no recorded diagnosis of CKD despite pathology consistent with a diagnosis. Older age and diagnosis of hypertension or hyperlipidaemia were associated with increased odds of CKD diagnosis being recorded. Older patients, males, those with recorded diagnoses of hypertension or hyperlipidaemia and those who had their medical record opened more frequently were more likely to be screened appropriately. Screening and monitoring of CKD appears suboptimal. Research to explore barriers to screening, recording and monitoring of CKD, and strategies to address these, is required.

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals Sociodemographic factors and health conditions associated with the resilience of people with chronic diseases: a cross sectional study

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Julia Estela Willrich Böell ◽  
Denise Maria Guerreiro Vieira da Silva ◽  
Kathleen Mary Hegadoren
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Study Participants

ABSTRACT Objective: to investigate the association between resilience and sociodemographic variables and the health of people with chronic kidney disease and / or type 2 diabetes mellitus. Method: a cross-sectional observational study performed with 603 people with chronic kidney disease and / or type 2 diabetes mellitus. A tool to collect socio-demographic and health data and the Resilience Scale developed by Connor and Davidson were applied. A descriptive and multivariate analysis was performed. Results: the study participants had on average 61 years old (SD= 13.2), with a stable union (52.24%), religion (96.7%), retired (49.09%), with primary education (65%) and income up to three minimum wages. Participants with kidney disease showed less resilience than people with diabetes. Conclusion: the type of chronic illness, disease duration, body mass index and religious beliefs influenced the resilience of the study participants.

scholarly journals Factors Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes in Bangladesh

2021 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Masudus Salehin ◽  
Sojib Bin Zaman ◽  
Tania Tansi ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Household Income ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Factors Associated

Diabetes and chronic kidney disease (CKD) are a major public health burden in low-and-middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on estimated Glomerular Filtration Rate using the ‘Modification of Diet in Renal Disease’ equations and presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model Factors associated with CKD were: aged 40-49 years (OR: 5.7, 95% CI: 1.3-25.4), age 50-59 years (7.0, 1.6-39), age ≥60 years (7.6, 1.7-34); being female (2.2, 1.2-3.8), hypertensive (1.9, 1.1-3.5) and household income between 128.2-256.4 US$ (2.9, 1.0-8.2) compared with income ≤128.2$. However, after adjustment of other covariates, only duration of hypertension and household income (128.2-256.4 US$) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

scholarly journals Factors Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes in Bangladesh

2021 ◽  
Vol 18 (23) ◽  
pp. 12277
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Masudus Salehin ◽  
Sojib Bin Zaman ◽  
Tania Tansi ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Household Income ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Factors Associated

Diabetes and chronic kidney disease (CKD) are a major public health burden in low- and middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on the estimated glomerular filtration rate using the ‘Modification of Diet in Renal Disease’ equations and the presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model, factors associated with CKD included age 40–49 years (OR: 5.7, 95% CI: 1.3–25.4), age 50–59 years (7.0, 1.6–39), age ≥60 years (7.6, 1.7–34), being female (2.2, 1.2–3.8), being hypertensive (1.9, 1.1–3.5), and household income between 10,001 and 20,000 Bangladeshi taka, BDT (2.9, 1.0–8.2) compared with income ≤10,000 BDT. However, after adjustment of other covariates, only the duration of hypertension and household income (10,001–20,000 BDT) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

Prescribing for people with type 2 diabetes and renal impairment in Australian general practice: A national cross sectional study

2019 ◽  
Vol 13 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Jo-Anne E. Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Janet K. Sluggett ◽  
Phyllis Lau ◽  
Irene Blackberry ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Renal Impairment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Australian General Practice

scholarly journals Clinical and laboratory characteristics of the patterns of chronic kidney disease in patients with type 2 diabetes

2020 ◽  
Vol 22 (6) ◽  
pp. 515-525
Author(s):  
Vadim V. Klimontov ◽  
Anton I. Korbut ◽  
Olga N. Fazullina ◽  
Ilya V. Vinogradov ◽  
Vyacheslav V. Romanov
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Urinary Excretion ◽  
Cross Sectional Study ◽  
Channel Blockers ◽  
Cross Sectional ◽  
Podocyte Injury

BACKGROUND: A growing body of evidence demonstrates increasing prevalence of normoalbuminuric chronic kidney disease (NA-CKD) in subjects with type 2 diabetes (T2D), while proportion of albuminuric pattern is decreasing. AIMS: To determine the clinical and laboratory parameters associated with different patterns of CKD in patients with T2D. METHODS: This observational, single-center, cross-sectional study included 360 patients with T2D duration 10 years. Patients with urinary albumin/creatinine ratio (UACR) 3 mg/mmol and estimated glomerular filtration rate (eGFR) 60 ml/min/1.73 m2 were classified as no-CKD group (n=89). Patients with UACR 3 mg/mmol and eGFR 60 ml/min/1.73 m2 formed NA-CKD group (n=111). Individuals with eGFR 60 ml/min/1.73 m2 and UACR mg/mmol 3 were recorded as albuminuric with preserved renal function (A-CKD, n=87). Patients with eGFR 60 ml/min/1.73 m2 and UACR mg/mmol 3 mg/mmol were considered as albuminuric CKD group (A-CKD+, n=73). Urinary nephrin and podocin, the podocyte injury markers, and whey acidic protein four-disulfide core domain protein 2 (WFDC-2), a marker of tubulointerstitial involvement, was assessed by ELISA and compared to control (20 non-diabetic subjects). RESULTS: Age 65 years (p=0.0001), duration of T2D 15 years (p=0.0009), female sex (p=0.04), and therapy with diuretics (p=0.0005) were found as risk factors for NA-CKD. The risk factors for A-CKD were male sex (p=0.01), smoking (p=0.01), waist-to-hip ratio 1 (p=0.01) and HbA1c levels 8% (p=0.005). The duration of T2D 15 years (p=0.01) and the use of dihydropyridine calcium channel blockers (p=0.01) were associated with A-CKD+. In T2D groups, the urinary excretion of nephrin and podocin was increased (all p0.001), more markedly in albuminuric individuals (p0.01 vs. NA-CKD). WFDC-2 excretion was increased in men from all diabetic groups (p0.05) and in women with decreased eGFR only (p0.05 vs. the control and NA-CKD). CONCLUSIONS: The CKD patterns in T2D are heterogeneous according to their clinical and laboratory characteristics. The changes in the excretion of nephrin and podocin indicate the association of albuminuric patterns with podocyte injury. A decrease in eGFR in women with T2D is associated with an increase in urinary excretion of WFDC-2, tubulointerstitial fibrosis marker.

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