Evaluating the effectiveness of screening for chronic kidney disease (CKD) in primary care by linking the OxRen/NewKi study with the Oxford RCGP Research and Surveillance Centre and NHS Digital
- Principal Investigator: Jennifer Hirst
- 1 September 2021 to 29 February 2024
- Project No: 526
- Funding round: FR1
Chronic Kidney Disease (CKD) affects around 3 million people in the United Kingdom. People with CKD are more likely to develop health problems, such as cardiovascular disease (condition affecting the heart and/or blood vessels), than the general population. However, although kidney function normally deteriorates as ageing progresses, most people do not develop CKD because their kidney function does not deteriorate beyond the point where it becomes a problem. CKD is commonly present in people with hypertension (high blood pressure), diabetes, and cardiovascular disease, who are routinely tested for CKD. Others, who appear healthy, are not tested and are therefore not diagnosed with CKD, even though it may be present. For most people, developing CKD does not affect their lives, but some people’s kidneys can deteriorate more quickly which can cause other health problems including a need for dialysis. It is important that these people receive treatment as early as possible to prevent them from getting worse. Currently, we do not know whether widespread testing of older people and early diagnosis of CKD, results in differences in older people’s care or changes in their health outcomes.
In 2013, a study at Oxford University tested a random selection of people aged over 60 years in several GP practices to establish whether they had CKD. Study participants who tested positive for CKD joined the Oxford Renal Study (OxRen), and detailed information was collected on their medical history and lifestyle. Blood samples were taken. Since then, the OxRen participants have been attending yearly study visits as part of a new study called NewKI to monitor their general health and kidney function.
Now, we want to find out how the health of people who already knew they had CKD compares with people in the study who did not know they had CKD before they joined our study, and those who had a borderline CKD test result. More precisely, we want to see how many people in each of these groups are currently living with other health problems and develop new ones, how many GP appointments they have, the numbers of medicines they are taking, and whether and when they were admitted to hospital or died.
We can obtain all these data from the Oxford Royal College of General Practitioners Research and Surveillance Centre database of routinely collected data for individual patients attending their GPs and link these data with the OxRen/NewKI data. We can also obtain data on hospital admissions, heart disease, cancer and death, from NHS Digital.
This will help us understand whether people who were found to have CKD after joining the study received different treatment, and whether they are taking more or fewer medicines than they need. It will also help us to understand whether it is important to test older people for CKD and help us to more accurately predict poor health outcomes and to improve care for older people with CKD in the future.
Co-applicant
José M. Ordóñez-Mena
Amount awarded: £40,000