| アブストラクト | BACKGROUND: Nephrologists support decision-making and preparation for kidney replacement therapy (KRT) and conservative kidney management (CKM). However, the frequency of nephrology review among people with chronic kidney disease (CKD) G5 has not been well characterised at the population level. METHODS: We identified adults in England who reached CKDG5 between 2013-2018 using Clinical Practice Research Datalink Aurum, a primary care database covering 16.1% of the UK population, linked to Hospital Episode Statistics. Review frequency was defined as the annualised number of 90-day quarters with >/=1 nephrology-coded outpatient attendance or inpatient admission during the 720 days before and after index. We examined factors associated with review frequency and estimated adjusted outcome probabilities. RESULTS: Among 4,781 patients (44.2% female; median age, 74 years), 872 (18.2%) died without KRT and 2,614 (54.7%) initiated KRT, including 795 (16.6%) inpatient dialysis initiations. Lower review frequency was associated with older age, female sex, greater deprivation, dementia, and cerebrovascular disease, whereas Asian and Black ethnicity were associated with higher frequency than White ethnicity. Lower review frequency was associated with less KRT initiation and higher proportions of death without KRT and inpatient dialysis initiation. CONCLUSIONS: We provide a population-based description of the heterogeneity in nephrology contact and subsequent treatment pathways among people reaching CKDG5 by age, sex, deprivation, frailty, comorbidity, and ethnicity. These observational data highlight the need to better understand equity in access to nephrology care and the diverse care needs of people with CKDG5 beyond preparation for KRT. |
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| ジャーナル名 | Journal of nephrology |
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| Pubmed追加日 | 2026/9/10 |
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| 投稿者 | Nakano, Yuta; Jones, Timothy; McLaren, Robert; Plumb, Lucy; Caskey, Fergus J; Hole, Barnaby |
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| 組織名 | Population Health Sciences, University of Bristol, Bristol, United Kingdom.;Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical;School, University of Bristol, Southmead Hospital, Bristol, United Kingdom.;Richard Bright Renal Unit, Southmead Hospital, North Bristol NHS Trust, Bristol,;United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42721298/ |
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