O ADEGBIJA1,2, A CAMERON1,2,3, D WAUGH5, D HOFFMAN4, T FREEMAN4, D SEGELOV4, S HUYNH3, WE HOY1,2
1School of Medicine, The University Of Queensland, Brisbane, Australia, 2NHMRC CKD.CRE and CKD.QLD, Brisbane, Australia, 3Kidney Health Service (RBWH); Metro North Hospital and Health Service, Brisbane, Australia, 4Software 4 Specialists, , Australia, 5Royal North Shore Hospital, Sydney, Australia
Aim: To present the first report from a private nephrology clinic in metropolitan Sydney utilising Audit4.
Background: In 2016, and to facilitate national surveillance efforts, CKD.QLD supported the development of an Audit4 extraction tool by Software-for-Specialists. This tool enables practitioners who utilise Audit4 as part of their practice software to abstract data.
Methods: We describe profiles of adult patients (18+ years over) seen from 2006 to 2016, reporting on features at the first recorded visit, and compared against descriptors in the CKD.QLD Registry.
Results: 2,998 individual patients were recorded. Of 2,764 patients not on RRT at first visit, 56% were males, mean and median ages were 64.1 and 68 years, and they made 6,288 visits (range 1-17). Where first recorded, eGFR (n=1,774) reflected proportions by CKD stages 1, 2, 3a, 3b, 4 and 5 of 11.7%, 30.1%, 26.8%, 19.2%, 7.2% and 5.0% respectively.
The number of “renal” ICD codes assigned to an individual ranged from 1 to 4 and 41% had more than one diagnosis. The top 6 were glomerular diseases (27.6%), hypertensive nephropathy (18.5%), urolithiasis (16.4%), tubulointerstitial diseases (15.8%), diabetic nephropathy (6.7%) and other conditions (6.4%). Proportions with dyslipidaemia, type 2 diabetes and hypertension were 19%, 23% and 60% respectively.
Conclusions: These CKD patients in a private nephrology clinic in metropolitan Sydney were similar in age, gender, CKD stage distribution, and frequency of multiple renal diagnoses to CKD patients in the public renal system in CKD.QLD. However the proportions with GN and urolithiasis were higher (27.6% vs 12%) and (16.4 vs 2.1), and with diabetic nephropathy and diabetes were lower (6.7% vs 24.7%) and (23% vs 45.9%). Socioeconomic factors may well play a role.
Professor Wendy Hoy is Director of the Centre for Chronic Disease at the University of Queensland. She is a graduate of Sydney University, with first class honours in Immunology (BScMed) and in Medicine and Surgery (MB BS), and is board certified in Medicine and Nephrology in the USA and Australia. She leads the CKD.QLD Collaborative and the NHMRC CKD Centre for Research Excellence. CKD.QLD is a core member of the iNET-CKD, an international research collaborative of CKD cohorts.