Iwagami Masao, Tomlinson Laurie A, Mansfield Kathryn E, Casula Anna, Caskey Fergus J, Aitken Grant, Fraser Simon D S, Roderick Paul J, Nitsch Dorothea
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
UK Renal Registry Bristol, UK.
Nephrol Dial Transplant. 2017 Apr 1;32(suppl_2):ii142-ii150. doi: 10.1093/ndt/gfw318.
Anonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry.
Among all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, according to their most recent serum creatinine in the past 5 years using the Chronic Kidney Disease Epidemiology Collaboration equation and patients with recorded diagnoses of RRT. Denominators were the entire population in each age-sex band irrespective of creatinine measurement. The prevalence of eGFR <60 mL/min/1.73 m2 was compared with that in the Health Survey for England (HSE) 2009/2010 and the prevalence of RRT was compared with that in the UK Renal Registry (UKRR) 2014.
We analysed 2 761 755 people in CPRD [mean age 53 (SD 17) years, men 49%], of whom 189 581 (6.86%) had an eGFR <60 mL/min/1.73 m2 and 3293 (0.12%) were on RRT. The prevalence of eGFR <60 mL/min/1.73 m2 in CPRD was similar to that in the HSE and the prevalence of RRT was close to that in the UKRR across all age groups in men and women, although the small number of younger patients with an eGFR <60 mL/min/1.73 m2 in the HSE might have hampered precise comparison.
UK primary care data have good external validity for the prevalence of decreased kidney function and RRT.
匿名的初级保健记录是观察性研究的重要资源。然而，其在识别肾功能下降和肾脏替代治疗（RRT）患病率方面的外部效度尚不清楚。因此，我们将临床实践研究数据链（CPRD）中肾功能下降和RRT的患病率与一项具有全国代表性的调查以及国家登记处进行了比较。
在2014年3月31日在CPRD登记≥1年的所有年龄≥25岁的人群中，我们根据他们过去5年中最近的血清肌酐，使用慢性肾脏病流行病学协作方程确定估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²的患者以及记录有RRT诊断的患者。分母是每个年龄 - 性别组中的全部人群，无论肌酐测量情况如何。将eGFR<60 mL/min/1.73 m²的患病率与2009/2010年英格兰健康调查（HSE）中的患病率进行比较，并将RRT的患病率与2014年英国肾脏登记处（UKRR）中的患病率进行比较。
我们分析了CPRD中的2761755人[平均年龄53（标准差17）岁，男性占49%]，其中189581人（6.86%）的eGFR<60 mL/min/1.73 m²，3293人（0.12%）接受RRT治疗。CPRD中eGFR<60 mL/min/1.73 m²的患病率与HSE中的患病率相似，并且RRT的患病率在所有年龄组的男性和女性中都与UKRR中的患病率接近，尽管HSE中eGFR<60 mL/min/1.73 m²的年轻患者数量较少可能妨碍了精确比较。
英国初级保健数据在肾功能下降和RRT患病率方面具有良好的外部效度。
