Accepted for/Published in: JMIR Research Protocols
Date Submitted: May 12, 2020
Date Accepted: Jul 14, 2020
Chronic kidney disease in Tasmania: Protocol for a Data Linkage Study.
ABSTRACT
Background:
Background:
Chronic kidney disease (CKD) is a significant and growing health burden globally. Tasmania has the highest state prevalence for non-Indigenous Australians, yet it has consistently had the lowest incidence and prevalence of dialysis in Australia.
Objective:
Objective:
To examine the gap between the high community prevalence of CKD in Tasmania and the low use of dialysis.
Methods:
Methods:
This is a retrospective cohort study using linked data from five health and two pathology datasets from the island state of Tasmania, Australia. The study population consists of any person (all ages including children) who had a blood measurement of creatinine with the included pathology providers between 1/1/2004 and 31/12/2017. This study population includes within it a CKD cohort, which were detected via pathology or documentation of kidney replacement therapy (dialysis or kidney transplant, KRT). Kidney function (eGFR) was calculated using CKD-EPI formula. Individuals with two measures of eGFR<60mL/min/1.73m2 , at least 90 days apart, were identified as having CKD and were included in the CKD cohort. Individuals treated with dialysis or transplant were identified from the Australia and New Zealand Dialysis and Transplant Registry.
Results:
Results:
The study population consisted of 460,737 people (53.3% female, mean age 47.4 years) who were Tasmanian residents aged 18 years and older and were followed for a median of 7.8 years. During the latter 5 years of the study period, 86.8% of Tasmanian adults were represented. The CKD cohort consisted of 56,437 people (12.2% of the study population; 54.0% female, mean age 69.9 years) followed for a median of 10.4 years with 56,043 detected via eGFR and 394 people detected via documentation of KRT. Approximately half (49.4%) of the study population and the majority of the CKD cohort (73.4%) had an admission episode. Of the 55,399 deaths recorded in the study population, 44.7% had CKD.
Conclusions:
Conclusions:
Whole of population approaches can be achieved by data linkage. Over this 14-year time period, CKD affected 12.2% of Tasmanian adult residents and was present in 45% of deaths.
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