1,721,398 research outputs found
On the level. Evidence for action on type 2 diabetes
No full textType 2 diabetes is a serious condition. It doubles the risk of cardiovascular disease, is the most common reason for severe kidney disease and is the second most common cause of blindness in working age adults. The disease is a major public health challenge, with many people not knowing they have diabetes and many more are at risk of developing it.NIHR research provides important insights throughout the patient pathway, from prevention to early identification to management of the disease and treating complications. These findings are helping to shape practice and policy. <br/
Epidemiology of AKI: Utilizing large databases to determine the burden of AKI
No full textLarge observational databases linking kidney function and other routine patient health data are increasingly being used to study acute kidney injury (AKI). Routine health care data show an apparent rise in the incidence of population AKI and an increase in acute dialysis. Studies also report an excess in mortality and adverse renal outcomes after AKI, although with variation depending on AKI severity, baseline, definition of renal recovery, and the time point during follow-up. However, differences in data capture, AKI awareness, monitoring, recognition, and clinical practice make comparisons between health care settings and periods difficult. In this review, we describe the growing role of large databases in determining the incidence and prognosis of AKI and evaluating initiatives to improve the quality of care in AKI. Using examples, we illustrate this use of routinely collected health data and discuss the strengths, limitations, and implications for researchers and clinicians.<br/
Kidney disease in the Global Burden of Disease Study 2017
No full textThe 2017 Global Burden of Disease Study analyses demonstrate the growing burden of chronic kidney disease (CKD), mainly driven by population ageing; absolute levels for every CKD metric considered rose significantly, whereas age-standardised rates were fairly stable. The prevalence of key metabolic CKD risk factors, particularly obesity, also show a worrying increase
Public health and nephrology: Contributions of epidemiology to the study, understanding, prevention and treatment of kidney disease
No full textChronic kidney disease: identification and management in primary care
No full textCKD is an important and common non-communicable condition globally. In national and international guidelines it is defined and staged according to measures of kidney function that allow for a degree of risk stratification using commonly available markers. It is often asymptomatic in its early stages and early detection is important to reduce future risk. The risk of cardiovascular outcomes is greater than the risk of progression to end stage kidney disease for most people with CKD. CKD also predisposes to acute kidney injury – a major cause of morbidity and mortality worldwide. Although only a small proportion of people with CKD progress to end stage kidney disease, renal replacement therapy (dialysis or transplantation) represent major costs for health care systems and burden for patients. Efforts in primary care to reduce the risks of cardiovascular disease, acute kidney injury and progression are therefore required. Monitoring renal function is an important task and primary care clinicians are well placed to oversee this aspect of care along with the management of modifiable risk factors, particularly blood pressure and proteinuria. Good primary care judgement is also essential in making decisions about referral for specialist nephrology opinion. As CKD commonly occurs alongside other conditions, consideration of comorbidities and patient wishes is important and primary care clinicians have a key role in coordinating care while adopting a holistic, patient-centred approach and providing continuity. This review aims to summarise the vital role that primary care plays in pre-dialysis CKD care and to outline the main considerations in its identification, monitoring and clinical management in this context
If we want to take prevention of multiple long term conditions seriously, then we need to know what we mean by that
No full textThe prevention of multiple long term conditions needs to be higher up the healthcare agenda and for this to happen we need to be more precise about what we mean when talking about it
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