Association Between Non-registration of Chronic Kidney Disease and Mortality and Cardiovascular Outcome: a Time-to-event Analysis of Retrospective Primary Care Data

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 May 13

PMID 38740502

Authors

Ine Van den Wyngaert

Pavlos Mamouris

Endale Alemayehu Ali

Bert Vaes

Gijs Van Pottelbergh

Affiliations

Soon will be listed here.

Abstract

Objective: Patients with impaired kidney function and increased albuminuria are at risk of developing cardiovascular disease (CVD). Previous research has revealed that a substantial proportion of patients with chronic kidney disease (CKD) do not get a registered diagnosis in the electronic health record of the general practitioner. The aim of this study was to investigate the association between non-registration of CKD and all-cause mortality and cardiovascular outcome.

Design And Setting: A retrospective study in primary care.

Methods: The analyses were carried out in the INTEGO database, a general practice-based morbidity registration network in Flanders, Belgium. The study used INTEGO data from the year 2018 for all patients ≥18 years old, including 10 551 patients. To assess the risk of mortality and CVD, a time-to-event analysis was performed. Cox proportional hazard model was used to evaluate the association between non-registration and incidence of all-cause mortality and cardiovascular events with mortality as a competing risk. Subgroup analyses were performed for estimated glomerular filtration rate stages (3A, 3B, 4 and 5). Multiple imputation was done following the methodology of Mamouris RESULTS: Mortality was higher in patients with non-registered CKD compared with patients with registered CKD (HR 1.29, 95% CI 1.19 to 1.41). Non-registration of CKD was not associated with an increased risk for the development of CVD (HR 0.92, 95% CI 0.77 to 1.11).

Conclusion: An association between non-registration and all-cause mortality was identified, although no such association was apparent for CVD.

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