Background
Methods
Sample
Data collection
Estimation of Chronic Kidney Disease prevalence
Statistical analysis
Results
Baseline characteristics of the population
Patient characteristics | Entire cohort | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |
---|---|---|---|---|---|---|---|---|
Count (n)
| 206,729 | 64,674 | 71,118 | 75,956 | 79,300 | 81,338 | 85,200 | 89,679 |
Demographics
| ||||||||
Age
| 54.2 (18.2) | 54.4 (18.4) | 54 (18.4) | 53.9 (18.4) | 54.1 (18.2) | 54.2 (18.2) | 54.4 (18.1) | 54.4 (18.1) |
Sex
| ||||||||
% Women | 54.1 | 54.6 | 54.0 | 54.3 | 54.4 | 54.2 | 53.6 | 53.9 |
% Men | 45.9 | 45.4 | 46.0 | 45.7 | 45.6 | 45.8 | 46.4 | 46.1 |
County of Residence (%)
| ||||||||
Donegal | 53.5 | 52.9 | 52.3 | 53.2 | 53.6 | 53.9 | 54.0 | 54.5 |
Sligo | 29.6 | 30.5 | 30.8 | 29.9 | 29.6 | 29.5 | 29.0 | 28.4 |
Leitrim | 12.4 | 12.0 | 12.2 | 12.4 | 12.3 | 12.3 | 12.6 | 12.6 |
Other County5
| 4.51 | 4.60 | 4.69 | 4.51 | 4.42 | 4.33 | 4.47 | 4.56 |
Location of Supervision (%)
2
| ||||||||
Outpatient Department | 7.1 | 5.3 | 4.5 | 4 | 7.8 | 8.7 | 8.7 | 9.5 |
General Practitioner | 67.8 | 64.3 | 67.4 | 68.2 | 67.7 | 67.6 | 69.3 | 69.4 |
Emergency Room | 15.1 | 17.3 | 16.3 | 16 | 14.4 | 14.5 | 14.1 | 14 |
Inpatient Location | 5.0 | 7.5 | 6.5 | 6.5 | 4.7 | 4.2 | 3.3 | 3.1 |
Outside facility | 5.0 | 5.6 | 5.2 | 5.3 | 5.5 | 5.0 | 4.7 | 4.0 |
Kidney Function () | ||||||||
Serum creatinine count | 1,388,625 | 171,922 | 183,565 | 199,533 | 205,493 | 203,938 | 204,204 | 219,970 |
Serum creatinine (μmol/L) | 80.1 (28.8) | 82.5 (33.4) | 81 (31) | 79.7 (29.2) | 78.6 (28) | 80 (27.3) | 79.4 (26.6) | 80.1 (26.8) |
Mean eGFR (ml/min/1.73 m2)3
| 86.8 (22.7) | 84.8 (23.2) | 86.4 (23.1) | 87.5 (22.9) | 88.2 (22.7) | 86.7 (22.5) | 87.2 (22.3) | 86.5 (22.4) |
Minimum GFR (ml/min/1.73 m2)3 (ml/min/1.73 m)2
| 84.2 (23.9) | 82.0 (24.5) | 83.7 (24.4) | 84.8 (24.3) | 85.6 (24) | 84.0 (23.7) | 84.7 (23.4) | 84.0 (23.5) |
Maximum eGFR (ml/min.73 m2)3
| 89.2 (22.4) | 87.4 (22.9) | 88.9 (22.8) | 90.0 (22.5) | 90.6 (22.3) | 89.1 (22.2) | 89.4 (22) | 88.8 (22.1) |
Serum Electrolytes () | ||||||||
Sodium (mmol/L) | 140.2 ( 2.8) | 140.1 (2.9) | 140.3 (2.8) | 140.2 (2.8) | 140.3 (2.8) | 139.9 (2.7) | 140.2 (2.7) | 140.5 (2.6) |
Potassium (mmol/L) | 4.5 ( 0.5) | 4.4 (0.5) | 4.5 (0.5) | 4.5 (0.5) | 4.5 (0.5) | 4.5 (0.5) | 4.5 (0.5) | 4.5 (0.5) |
Urea (mmol/L) | 6.2 ( 2.7) | 6.1 (2.8) | 6.1 (2.7) | 6.1 (2.7) | 6.3 (2.7) | 6.3 (2.7) | 6.3 (2.6) | 6.1 (2.6) |
Calcium (mmol/L) | 2.3 ( 0.1) | 2.4 (0.1) | 2.3 (0.1) | 2.3 (0.1) | 2.3 (0.1) | 2.3 (0.1) | 2.3 (0.1) | 2.3 (0.1) |
Phosphorous (mmol/L) | 1.1 ( 0.2) | 1.1 (0.2) | 1.1 (0.2) | 1.2 (0.2) | 1.1 (0.2) | 1.1 (0.2) | 1.1 (0.2) | 1.1 (0.2) |
Hematology Variables
| ||||||||
Haemoglobin (g/dl) | 13.8 (1.6) | 13.8 (1.6) | 13.9 (1.6) | 13.9 (1.6) | 13.7 (1.6) | 13.7 (1.6) | 13.7 (1.6) | 13.8 (1.6) |
Serum ferritin ng/ml | 130.9 (286.4) | 127.3 (295.1) | 124.0 (341.6) | 127.8 (236.8) | 128.6 (228) | 135.8 (396.3) | 132.7 (223.2) | 137.2 (254.2) |
Other Laboratory Variables
| ||||||||
Serum uric acid (UA) (μmol/L) | 355.7(109.5) | 369.4(119.6) | 352.7 (111.8) | 346.8 (106.5) | 352.2 (106.5) | 355.7 (108.9) | 354.5 (106.5) | 362.9 (108.9) |
Acute Kidney Injury
4
| ||||||||
% with AKI | 3.2 | 3.3 | 3.5 | 3.4 | 3.2 | 3.1 | 2.8 | 3.0 |
% of AKI in patients with no CKD | 2.0 | 1.9 | 2.2 | 2.11 | 1.99 | 2.0 | 1.8 | 1.9 |
% of AKI in patients with CKD | 12.6 | 12.0 | 12.9 | 13.68 | 13.41 | 12.2 | 12.0 | 12.1 |
Prevalence of CKD in the Irish Health System
CKD-EPI equation1
| 95% CI | MDRD equation2
| 95% CI | |
---|---|---|---|---|
Overall Prevalence (%)
| 11.8 | (11.8-12.1) | 13.5 | (13.3-13.6) |
By Stage (%)
| ||||
Stage 3 CKD | 10.7 | (10.6-10.9) | 12.5 | (12.4-12.7) |
Stage 4 CKD | 0.95 | (0.94-0.99) | 0.83 | (0.79-0.87) |
Stage 5 CKD (No dialysis) | 0.15 | (0.14-0.17) | 0.14 | (0.12-0.15) |
Stage 5 CKD (Dialysis only)3
| 0.07 | (0.06-0.09) | 0.07 | (0.06-0.09) |
By Age group (%)
4
| ||||
18-39 | 0.45 | (0.39-0.51) | 0.93 | (0.9-1.0) |
40-59 | 2.24 | (2.13-2.35) | 4.55 | (4.4-4.7) |
60-80 | 18.9 | (18.6-19.3) | 22.0 | (21.6-22.3) |
> 80 | 55.7 | (54.9-56.4)* | 52.4 | (51.6-53.1) |
By Gender (%)
4
| ||||
Women | 12.6 | (12.4-12.8) | 15.0 | (14.8-15.2) |
Men | 10.9 | (10.7-11.1)* | 11.7 | (11.5-11.9) |
By County (%)
4
| ||||
Donegal | 12.0 | (11.7-12.2) | 13.5 | (13.3-13.8) |
Sligo | 11.3 | (11.0-11.6) | 13.1 | (12.7-13.4) |
Leitrim | 12.8 | (12.3-13.3) | 14.6 | (14.1-15.1) |
All other counties6
| 11.6 | (11.1-12.0)* | 13.2 | (12.8,13.7) |
By Acute Kidney Injury (%)
5
| ||||
No AKI | 10.7 | (10.6-10.9) | 12.5 | (12.3-12.6) |
History of AKI | 45.2 | (44.3-46.1)* | 45.5 | (44.6-46.3) |
By Number of AKI Episodes (%)
| ||||
0 | 10.9 | (10.7-11) | 12.4 | (12.3-12.6) |
1 | 39.1 | (38.2-40) | 39.5 | (38.6-40.5) |
2 | 54.8 | (52.9-56.8) | 54.8 | (52.8-56.7) |
3 | 64.8 | (61.4-68.1) | 63.4 | (59.9-66.8) |
4 | 64.1 | (58.4-69.3) | 65.4 | (59.8-70.6) |
≥5 | 88.7 | (85.9-91.0)*
| 88.9 | (86.1-91.1) |
Prevalence of detectable CKD in the Irish population
CKD-EPI equation2
| 95% CI | MDRD equation3
| 95% CI | |
---|---|---|---|---|
Overall Prevalence (%)
| 4.5 | (4.46-4.59) | 5.2 | (5.09-5.23) |
By Stage (%)
| ||||
Stage3 | 4.10 | (4.04-4.16) | 4.78 | (4.71-4.84) |
Stage 4 | 0.37 | (0.35-0.38) | 0.32 | (0.31-0.34) |
Stage 5 (No Dialysis) | 0.06 | (0.05-0.062) | 0.05 | (0.044-0.055) |
Stage 5 (Dialysis only) | 0.03 | (0.025-0.035) | 0.03 | (0.025-0.035) |
By Age group (years) (%)
| ||||
18-39 | 0.09 | (0.08,0.10) | 0.18 | (0.17,0.20) |
40-59 | 0.88 | (0.83,0.92) | 1.79 | (1.73,1.86) |
60-80 | 13.0 | (12.8,13.2) | 15.10 | (14.85,15.36) |
> 80 | 48.9 | (48.2,49.6)*
| 46.09 | (45.39-46.79)*
|
By Gender (%)
| ||||
Women | 5.1 | (5.02-5.22) | 6.1 | (5.98-6.19) |
Men | 3.9 | (3.83-4.00)*
| 4.2 | (4.10-4.28)*
|
CKD-EPI | 95% CI | MDRD | 95% CI | |
---|---|---|---|---|
Prevalence based on North West Regional Database (%)
1
| ||||
Overall | 9.7 | (9.6-9.9) | 10.9 | (10.8-11.1) |
Women | 11.0 | (10.8-11.2) | 12.9 | (12.7-13.1) |
Men | 8.4 | (8.2-8.6)* | 8.9 | (8.7-9.1) |
Prevalence based on SLAN Survey (%)
2
| ||||
Overall | 11.6 | (9.0-14.2) | 15.7 | (12.7,18.7) |
Women3
| 11.2 | (7.3,15.2) | ||
Men | 12.0 | (9.0,14.2) |
Period trends in CKD prevalence in the Irish Health System and General Population
Entire cohort | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | |
---|---|---|---|---|---|---|---|---|
Count (n)
| 206,729 | 64,674 | 71,118 | 75,956 | 79,300 | 81,338 | 85,200 | 89,679 |
Overall Prevalence
| 11.9 | 13.8 | 12.4 | 11.6 | 10.9 | 11.8 | 11.4 | 11.8 |
By stage
| ||||||||
3 | 10.73 | 12.4 | 11.2 | 10.5 | 9.8 | 10.7 | 10.3 | 10.7 |
4 | 0.95 | 1.18 | 1.09 | 0.96 | 0.87 | 0.87 | 0.83 | 0.88 |
5 | 0.15 | 0.26 | 0.18 | 0.16 | 0.15 | 0.13 | 0.11 | 0.12 |
By Gender
| ||||||||
Women | 12.7 | 14.9 | 13.3 | 12.3 | 11.6 | 12.4 | 12.0 | 12.3 |
Men | 10.9 | 12.5 | 11.4 | 10.7 | 10.0 | 10.9 | 10.3 | 10.9 |
By Age group
| ||||||||
18-39 | 0.4 | 0.6 | 0.5 | 0.5 | 0.4 | 0.5 | 0.3 | 0.4 |
40-59 | 2.2 | 2.9 | 2.5 | 2.2 | 2.1 | 2.2 | 2.0 | 2.0 |
60-80 | 18.9 | 22.8 | 20.4 | 18.8 | 17.1 | 18.6 | 17.3 | 18.3 |
> 80 | 55.6 | 58.6 | 56.5 | 54.4 | 52.5 | 56.3 | 55.5 | 56.0 |
By age group (females)
| ||||||||
18-39 | 0.35 | 0.48 | 0.36 | 0.32 | 0.33 | 0.41 | 0.33 | 0.25 |
40-59 | 2.18 | 2.8 | 2.5 | 2.2 | 2.0 | 2.0 | 1.9 | 2.0 |
60-80 | 20.40 | 24.9 | 22.1 | 20.2 | 18.5 | 20.2 | 18.6 | 19.6 |
> 80 | 57.63 | 60.7 | 57.9 | 56.6 | 54.5 | 58.2 | 57.6 | 58.3 |
By age group (males)
| ||||||||
18-39 | 0.6 | 0.6 | 0.6 | 0.8 | 0.6 | 0.6 | 0.4 | 0.6 |
40-59 | 2.3 | 2.9 | 2.5 | 2.2 | 2.2 | 2.4 | 2.1 | 2.1 |
60-80 | 17.4 | 20.6 | 18.7 | 17.4 | 15.7 | 17.0 | 16.1 | 17.0 |
> 80 | 52.4 | 55.3 | 54.1 | 50.8 | 49.4 | 53.3 | 52.2 | 52.4 |
By Geographic origin
| ||||||||
Sligo | 11.3 | 13.6 | 12.0 | 11.1 | 10.6 | 10.7 | 10.5 | 11.0 |
Donegal | 12.0 | 13.5 | 12.4 | 11.7 | 10.8 | 12.2 | 11.5 | 12.0 |
Leitrim | 12.8 | 15.4 | 13.5 | 12.1 | 12.0 | 12.8 | 12.3 | 12.4 |
All other counties | 11.6 | 13.9 | 12.5 | 11.4 | 10.7 | 10.8 | 10.3 | 11.1 |
By Acute Kidney Injury
2
| ||||||||
No AKI | 10.7 | 12.6 | 11.2 | 10.4 | 9.8 | 10.7 | 10.3 | 10.7 |
With AKI | 45.2 | 50.8 | 45.5 | 45.6 | 44.3 | 42.4 | 44.3 | 44.6 |
Factors associated with CKD prevalence in the Health System
Variable | Odds ratio | 95% CI | P-value | Odds ratio | 95% CI | P-value |
---|---|---|---|---|---|---|
Adjusted demographics2
| Adjusted all factors3
| |||||
Demographic factors
| ||||||
Age group (years)
| ||||||
18-39 | 1.00 (referent) | 1.00 (referent) | ||||
40-59 | 5.0 | (4.32,5.78) | <.0001 | 5.14 | (4.46,5.92) | <.0001 |
60-79 | 50.27 | (43.74,57.79) | <.0001 | 51.17 | (44.68,58.59) | <.0001 |
> = 80 | 265.74 | (230.83,305.88) | <.0001 | 260.66 | (227.26,298.93) | <.0001 |
Sex
| ||||||
Women (vs. men) | 1.17 | (1.13,1.22) | <.0001 | 1.21 | (1.17,1.26) | <.0001 |
Location of supervision
| ||||||
General Practice (GP) | 1.00 (referent) | 1.00 (referent) | ||||
Emergency room vs. GP | 1.04 | (1.01,1.08) | 0.01 | 0.90 | (0.87,0.94) | <.0001 |
Inpatient location vs. GP | 1.17 | (1.12,1.23) | < .0001 | 0.87 | (0.83,0.91) | <.0001 |
Outpatient Department vs. GP | 1.64 | (1.58,1.72) | < .0001 | 1.50 | (1.44,1.57) | <.0001 |
Outside facility vs. GP | 1.13 | (1.06,1.19) | < .0001 | 1.09 | (1.03,1.15) | 0.004 |
Calendar Year
| ||||||
2005 | 1.00 (referent) | 1.00 (referent) | ||||
2006 vs. 2005 | 0.88 | (0.85,0.90) | < .0001 | 0.87 | (0.84,0.89) | <.0001 |
2007 vs. 2005 | 0.79 | (0.76,0.81) | < .0001 | 0.79 | (0.76,0.81) | <.0001 |
2008 vs. 2005 | 0.72 | (0.69,0.74) | < .0001 | 0.71 | (0.68,0.73) | <.0001 |
2009 vs. 2005 | 0.80 | (0.77,0.82) | < .0001 | 0.78 | (0.76,0.81) | <.0001 |
2010 vs. 2005 | 0.74 | (0.72,0.76) | < .0001 | 0.73 | (0.71,0.76) | <.0001 |
2011 vs. 2005 | 0.78 | (0.76,0.80) | < .0001 | 0.77 | (0.74,0.79) | <.0001 |
# Acute Kidney Injury
4
episodes
| ||||||
0 | 1.00 (referent) | 1.00 (referent) | ||||
1 vs. 0 | 2.36 | (2.24,2.48) | < .0001 | 2.41 | (2.29,2.54) | <.0001 |
2 vs. 0 | 4.11 | (3.71,4.54) | < .0001 | 4.20 | (3.79,4.65) | <.0001 |
3 vs. 0 | 7.19 | (5.90,8.77) | < .0001 | 7.39 | (6.06,9.02) | <.0001 |
4 vs. 0 | 9.44 | (6.74,13.1) | < .0001 | 9.70 | (6.94,13.55) | <.0001 |
5 vs. 0 | 120.0 | (79.7,180.6) | < .0001 | 102.56 | (69.15,152.09) | <.0001 |
County of Residence
| ||||||
Sligo | 1.00 (referent) | 1.00 (referent) | ||||
Donegal vs. Sligo | 1.05 | (1.01,1.10) | 0.02 | 1.07 | (1.02,1.11) | 0.0035 |
Leitrim vs. Sligo | 1.08 | (1.02,1.14) | 0.01 | 1.09 | (1.03,1.16) | 0.0031 |
Other counties vs. Sligo | 1.03 | (0.97,1.09) | 0.30 | 1.07 | (1.01,1.13) | 0.0244 |
Primary Hospital
5
| ||||||
Letterkenny vs. Sligo6
| 1.00 | (0.96,1.03) | 0.88 |