ArticleBMJ open2022
Association between practice coding of chronic kidney disease (CKD) in primary care and subsequent hospitalisations and death: a cohort analysis using national audit data.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- A Pilot Study of Opportunistic Chronic Kidney Disease Screening in Primary Care Using a Clinical Decision Support System.Diagnostics (Basel, Switzerland) · 2025Article
- The association between coding for chronic kidney disease and kidney replacement therapy incidence at CCG-level in England: an ecological study.BJGP open · 2025Article
- Coded and uncoded chronic kidney disease: an explainer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Temporal Changes in Blood Metabolome Among Patients on Hemodialysis.Kidney international reports · 2025Article
- Uncoded chronic kidney disease prevalence in secondary care: a retrospective audit with population health implications.BMC nephrology · 2025Article
- Referral, monitoring, and factors associated with non-referral of chronic kidney disease in Germany: a nationwide, retrospective cohort study.The Lancet regional health. Europe · 2024Article
- An updated systematic review of the risk factors for unplanned dialysis initiation.Clinical kidney journal · 2024Review
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Authors and funding
13 authors at 9 institutions in 2 countries.
Funding
Abstract
objectiveTo examine the association between practice percentage coding of chronic kidney disease (CKD) in primary care with risk of subsequent hospitalisations and death.
designRetrospective cohort study using linked electronic healthcare records.
setting637 general practitioner (GP) practices in England.
participants167 208 patients with CKD stages 3-5 identified by 2 measures of estimated glomerular filtration rate <60 mL/min/1.73 m
main outcome measuresHospitalisations with cardiovascular (CV) events, heart failure (HF), acute kidney injury (AKI) and all-cause mortality
resultsParticipants were followed for (median) 3.8 years for hospital outcomes and 4.3 years for deaths. Rates of hospitalisations with CV events and HF were lower in practices with higher percentage CKD coding. Trends of a small reduction in AKI but no substantial change in rate of deaths were also observed as CKD coding increased. Compared with patients in the median performing practice (74% coded), patients in practices coding 55% of CKD cases had a higher rate of CV hospitalisations (HR 1.061 (95% CI 1.015 to 1.109)) and HF hospitalisations (HR 1.097 (95% CI 1.013 to 1.187)) and patients in practices coding 88% of CKD cases had a reduced rate of CV hospitalisations (HR 0.957 (95% CI 0.920 to 0.996)) and HF hospitalisations (HR 0.918 (95% CI 0.855 to 0.985)). We estimate that 9.0% of CV hospitalisations and 16.0% of HF hospitalisations could be prevented by improving practice CKD coding from 55% to 88%. Prescription of antihypertensives was the most dominant predictor of a reduction in hospitalisation rates for patients with CKD, followed by albuminuria testing and use of statins.
conclusionsHigher levels of CKD coding by GP practices were associated with lower rates of CV and HF events, which may be driven by increased use of antihypertensives and regular albuminuria testing, although residual confounding cannot be ruled out.
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