Renal Services (Toowoomba Hospital), Darling Downs Health, Toowoomba, Queensland, Australia.
NHMRC CKD.CRE and CKD.QLD, University of Queensland, Brisbane, Queensland, Australia.
Nephrology (Carlton). 2019 Dec;24(12):1257-1264. doi: 10.1111/nep.13567. Epub 2019 May 2.
Chronic kidney disease, Queensland (CKD.QLD) is a multidisciplinary, collaborative research platform for CKD in Queensland. Most public renal services contribute towards the CKD Registry, including Toowoomba Hospital, which is a referral hospital for Darling Downs Health serving a largely regional population in Queensland. We aim to present the profile of the CKD cohort recruited to the CKD.QLD Registry from Toowoomba Hospital, the first comprehensive report on a pre-dialysis population from regional Australia.
Study subjects were patients in the Darling Downs Health Service who consented to be included in the CKD.QLD registry from June 2011 to December 2016. Those who were on renal replacement therapy (RRT) were excluded. Patients were followed until date of RRT, death, discharge or loss to follow up or a censor date of 30th June 2017.
Overall 1051 subjects, representing 13% of all CKD.QLD Registry patients gave consent of whom, 42.7% were ≥70 years of age. The mean age was 63.8 ± 15.1 years (median age 67 years) with male predominance (55.4%). The majority were born in Australia (86.4%). Aboriginal and Torre Strait Islanders (A&TSI) constituted 9.6% of the cohort. The predominant CKD stages were 3b (28.9%) and 4 (27.7%). Hypertension and diabetes were noted in 91% and 44% of subjects, respectively. Diabetic nephropathy was the leading cause of CKD (26.7%) followed by renovascular disease (17.3%) and glomerulonephritis (14.8%). In 12%, the diagnosis was uncertain. Major co-morbidities included coronary artery disease (24.7%) chronic lung disease (14.8%), cerebrovascular disease (11.6%) and peripheral vascular disease (8.9%). Non-vascular co-morbidities included arthritis (24.6%), gout (23.6%) and gastro-oesophageal reflux disease (19%). The multi-morbidity profile was differed by gender, diabetic status and age. Over a follow-up period upto 72 months, 93 (8.8%) started RRT and 175 (16.6%) died. Of those 82% died without RRT and 18% died after RRT.
This CKD Registry cohort from regional Queensland consisted mainly of older Caucasians with male predominance. A&TSI patients were overrepresented compared to the overall population. A significant proportion had cardio-vascular disease and multiple co-morbidities which differed by gender, diabetic status and age. This report provides valuable data for health services planning and delivery in regional Queensland.
昆士兰慢性肾病（CKD.QLD）是昆士兰 CKD 的多学科协作研究平台。大多数公共肾脏服务机构都为 CKD 登记处做出了贡献，包括汤斯维尔医院，它是达令唐斯健康服务的转诊医院，为昆士兰州的大部分地区人口提供服务。我们旨在介绍从汤斯维尔医院招募到 CKD.QLD 登记处的 CKD 队列的特征，这是澳大利亚地区首个关于透析前人群的综合报告。
研究对象为 2011 年 6 月至 2016 年 12 月期间同意纳入 CKD.QLD 登记处的达令唐斯卫生服务中心的患者。排除接受肾脏替代治疗（RRT）的患者。患者随访至 RRT 开始、死亡、出院或失访或 2017 年 6 月 30 日截止日期。
总体而言，1051 名患者表示同意，占 CKD.QLD 登记处所有患者的 13%，其中 42.7%年龄≥70 岁。平均年龄为 63.8±15.1 岁（中位数年龄为 67 岁），男性居多（55.4%）。大多数患者出生在澳大利亚（86.4%）。原住民和托雷斯海峡岛民（A&TSI）占队列的 9.6%。主要 CKD 分期为 3b（28.9%）和 4（27.7%）。91%和 44%的患者分别患有高血压和糖尿病。糖尿病肾病是 CKD 的主要病因（26.7%），其次是肾血管疾病（17.3%）和肾小球肾炎（14.8%）。在 12%的病例中，诊断不确定。主要合并症包括冠状动脉疾病（24.7%）、慢性肺部疾病（14.8%）、脑血管疾病（11.6%）和外周血管疾病（8.9%）。非血管合并症包括关节炎（24.6%）、痛风（23.6%）和胃食管反流病（19%）。性别、糖尿病状况和年龄的不同，导致了合并症的多态性。在长达 72 个月的随访期间，93 人（8.8%）开始接受 RRT，175 人（16.6%）死亡。其中 82%的人在没有接受 RRT 的情况下死亡，18%的人在接受 RRT 后死亡。
该队列主要由昆士兰州的老年白种人组成，男性居多。与总体人口相比，原住民和托雷斯海峡岛民患者人数过多。相当一部分患者患有心血管疾病和多种合并症，其性别、糖尿病状况和年龄存在差异。本报告为昆士兰州地区的卫生服务规划和提供提供了有价值的数据。
