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Chronic kidney disease in the Top End of the Northern Territory of Australia, 2002-2011: a retrospective cohort study using existing laboratory data

Lawton, Paul D., Cunningham, Joan, Hadlow, Narelle, Zhao, Yuejen and Jose, Matthew D. (2015). Chronic kidney disease in the Top End of the Northern Territory of Australia, 2002-2011: a retrospective cohort study using existing laboratory data. BMC Nephrology,16(Article No. 168).

Document type: Journal Article
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IRMA ID 83393865xPUB196
Title Chronic kidney disease in the Top End of the Northern Territory of Australia, 2002-2011: a retrospective cohort study using existing laboratory data
Author Lawton, Paul D.
Cunningham, Joan
Hadlow, Narelle
Zhao, Yuejen
Jose, Matthew D.
Journal Name BMC Nephrology
Publication Date 2015
Volume Number 16
Issue Number Article No. 168
ISSN 1471-2369   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84944705314
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
The Northern Territory of Australia has a very high incidence of treated end-stage kidney disease (ESKD), largely confined to Indigenous Australians living in remote, under-resourced areas. Surveillance of chronic kidney disease (CKD) is still in its infancy in Australia. We estimate the prevalence and rate of progression of measured CKD across a region using inexpensive readily available laboratory information.

Methods

Using a retrospective de-identified extraction of all records with a serum creatinine or urinary albumin-to-creatinine ratio from the single largest ambulatory pathology provider to the Top End of the Northern Territory of Australia between 1st February 2002 and 31st December 2011, the yearly total and age-specific prevalence of measured microalbuminuria, overt albuminuria and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, and the prevalence of progressive CKD, were calculated.

Results
There was a steady increase in the proportion tested across all health districts in the region, more prominent in non-urban districts. In 2009, the regional adult prevalence of measured microalbuminuria and overt albuminuria was as high as 8.1 %, overt albuminuria alone up to 3.0 % and eGFR < 60 up to 2.3 %. Rates of progressive disease were extremely high, particularly for those with albuminuria (53.1–100 % for those with urinary albumin-creatinine ratio > 300 mg/mmol).

Conclusions
The rates of testing, particularly in districts of high measured prevalence of markers of CKD, are encouraging. However, extremely high rates of progressive CKD are troubling. Further describing the outcomes of CKD in this population would require analysis of linked datasets.
Keywords Chronic kidney disease
Estimated glomerular filtration rate
Creatinine
Urinary albumin-creatinine ratio
Public health surveillance
DOI http://dx.doi.org/10.1186/s12882-015-0166-6   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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