The evolution of renal function and the incidence of end-stage renal disease in patients aged

Abstract Background. The prevalence of chronic kidney disease (CKD) is high, especially among older patients. Methods. In order to identify risk factors for the evolution towards end-stage renal disease (ESRD), a cohort of patients !50 years of age for whom at least four serum creatinine measurements were available were selected from a primary care-based database. The slope of changes in estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease formula) was calculated, and ESRD was defined as eGFR <15 mL/min. Risk factors for ESRD were analysed using Cox regression analysis. Conclusions. Baseline eGFR, diabetes, high cholesterol, high LDL, hypertension and female gender are independent risk factors for developing ESRD. Older age at baseline predicts a lower risk

Methodology used in studies reporting chronic kidney disease prevalence: a systematic literature review

Background Many publications report the prevalence of chronic kidney disease (CKD) in the general population. Comparisons across studies are hampered as CKD prevalence estimations are influenced by study population characteristics and laboratory methods. Methods For this systematic review, two researchers independently searched PubMed, MEDLINE and EMBASE to identify all original research articles that were published between 1 January 2003 and 1 November 2014 reporting the prevalence of CKD in the European adult general population. Data on study methodology and reporting of CKD prevalence results were independently extracted by two researchers. Results We identified 82 eligible publications and included 48 publications of individual studies for the data extraction. There was considerable variation in population sample selection. The majority of studies did not report the sampling frame used, and the response ranged from 10 to 87%. With regard to the assessment of kidney function, 67% used a Jaffe assay, whereas 13% used the enzymatic assay for creatinine determination. Isotope dilution mass spectrometry calibration was used in 29%. The CKD-EPI (52%) and MDRD (75%) equations were most often used to estimate glomerular filtration rate (GFR). CKD was defined as estimated GFR (eGFR) <60 mL/min/1.73 m2 in 92% of studies. Urinary markers of CKD were assessed in 60% of the studies. CKD prevalence was reported by sex and age strata in 54 and 50% of the studies, respectively. In publications with a primary objective of reporting CKD prevalence, 39% reported a 95% confidence interval. Conclusions The findings from this systematic review showed considerable variation in methods for sampling the general population and assessment of kidney function across studies reporting CKD prevalence. These results are utilized to provide recommendations to help optimize both the design and the reporting of future CKD prevalence studies, which will enhance comparability of study result

The BELFRAIL (BFC80+) study: a population-based prospective cohort study of the very elderly in Belgium

In coming decades the proportion of very elderly people living in the Western world will dramatically increase. This forthcoming "grey epidemic" will lead to an explosion of chronic diseases. In order to anticipate booming health care expenditures and to assure that social security is funded in the future, research focusing on the relationship between chronic diseases, frailty and disability is needed. The general aim of the BELFRAIL cohort study (BFC80+) is to study the dynamic interaction between health, frailty and disability in a multi-system approach focusing on cardiac dysfunction and chronic heart failure, lung function, sarcopenia, renal insufficiency and immunosenescence

sentinel surveillance networks in primary care

status: accepte

hoe wordt COPD in Vlaanderen opgevolgd?

status: publishe

The diagnosis and outcome of chronic kidney disease in older persons

The prevalence of chronic kidney disease (CKD) is increasing with aging. Approximately 1 out of 2 persons with CKD meets the criteria of CKD (an eGFR<60 ml/min). In this thesis we try to answer two research questions: “What are the consequences of an impaired eGFR?” and “What method or equation do we use to estimate or measure the GFR in older persons. In a first “epidemiological” part the outcomes of CKD and the factors predicting higher chances for important outcomes are analyzed. These analyses are performed on the data of 2 prospective population based studies (BELFRAIL and Leiden85+) and a primary care morbidity registry (Intego). The second part of this thesis reports our search for a reliable method to measure the GFR in older persons. This search included a systematic literature search, an analysis of the differences between different GFR estimating equations, an experimental part were the GFR in older persons was measured using the clearance of iohexol and the protocol of a new study.(MED 3) -- UCL, 201

Reorganisatie van de eerstelijnszorg in Vlaanderen : aandachtspunten op weg naar meer patiëntgerichte zorg

Query date: 2019-12-23 16:38:43status: publishe