Evidence map›Paper›PMID 40038631›Full record

ArticleBMC nephrology2025

Analysis of the kidney failure risk equation implementation in routine clinical practice and health inequalities in chronic kidney disease care: a retrospective cohort study.

Heather Walker, Shabana Khan, Sandosh Padmanabhan, Jill P Pell, Jim Lewsey, Daniel Mackay, Ruth Dundas, Jocelyn M Friday, Tran Q B Tran, Denise Brown and 10 more

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In one paragraph

Article in BMC nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Heather WalkerSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland. heather.walker.2@glasgow.ac.uk.
Shabana KhanRobertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland.
Sandosh PadmanabhanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.
Jill P PellPublic Health, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Jim LewseyHealth Economics & Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Daniel MackayPublic Health, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Ruth DundasMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
Jocelyn M FridaySchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.
Tran Q B TranSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.
Denise BrownMRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland.
Frederick HoPublic Health, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Claire E HastiePublic Health, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Michael FlemingPublic Health, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Claudia GeueHealth Economics & Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Alan StevensonRobertson Centre for Biostatistics, University of Glasgow, Glasgow, Scotland.
Clea Du ToitDigital Health Validation Lab, Living Lab, University of Glasgow, Glasgow, Scotland.
Bhautesh Dinesh JaniGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Katie GallacherGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Patrick B MarkSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.
Michael K SullivanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.

Funding

British Heart Foundation Centre for Research Excellence RE/18/6/34217Chief Scientist Office, Scottish Government Health and Social Care Directorate SPHSU17Medical Research Council MC_UU_00022/2UKRI Strength in Places Fund SIPF00007/1Wellcome TrustWellcome Trust 223499/Z/21/Z
6 · The paper itself

Abstract

backgroundNICE guidelines recommend GPs use the kidney failure risk equation (KFRE) to identify people with chronic kidney disease (CKD) at higher risk of kidney failure. Albuminuria results are required to calculate KFRE.

aimAnalyse the implementation of KFRE into clinical practice and investigate if albuminuria testing varied amongst patients with CKD, particularly for underserved groups. DESIGN AND

settingRetrospective cohort study of 23,063 adults in Glasgow from 2013 to 2022.

methodWe evaluated albuminuria testing rates and the predictive performance of KFRE in estimating 5-year kidney failure risk amongst people with CKD. Logistic regression models quantified associations between demographic/clinical variables and albuminuria testing. Amongst people who developed kidney failure, we retrospectively assessed the impact of KFRE on the timing of meeting criteria for referral to renal services.

resultsAlbuminuria testing was performed in 44.5% of 10,874 adults with CKD. Females (adjusted odds ratio (aOR) 0.86: 95% CI 0.79-0.93) and those with hypertension (aOR 0.69: 95% CI 0.63-0.77) were less likely to have albuminuria testing. Those aged 40-50 years (aOR 1.83: 95% CI 1.15-2.91), with diabetes (aOR 2.35: 95% CI 2.14-2.58) and living in the least socioeconomically deprived areas (aOR 1.11: 95% CI 1.00-1.23) were more likely to have albuminuria testing. Of 1,352 individuals with incident kidney failure, incorporating KFRE into referral guidelines helped identify high-risk patients early.

conclusionKFRE could be calculated for less than half of people due to lack of albuminuria testing. Focus should be given to improving albuminuria testing and inequities identified to allow wider implementation of KFRE.

Indexed as

AlbuminuriaHealthcare DisparitiesRenal InsufficiencyRenal Insufficiency, ChronicAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedReferral and ConsultationRetrospective StudiesRisk AssessmentRisk FactorsScotlandAlbuminuriaChronic kidney diseaseHealth inequalityHospital referralsKidney failure risk equation

Identifiers

PMID40038631
PMCPMC11881359

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.