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Abstract

Background: Chronic kidney disease (CKD) is a significant and growing health burden globally. Tasmania has the highest state prevalence for non-Indigenous Australians and it has consistently had the lowest incidence and prevalence of dialysis in Australia.Objective: To examine the gap between the high community prevalence of CKD in Tasmania and the low use of dialysis.Methods: This is a retrospective cohort study using linked data from 5 health and 2 pathology data sets from the island state of Tasmania, Australia. The study population consists of any person (all ages including children) who had a blood measurement of creatinine with the included pathology providers between January 1, 2004, and December 31, 2017. This study population (N=460,737) includes within it a CKD cohort, which was detected via pathology or documentation of kidney replacement therapy (KRT; dialysis or kidney transplant). Kidney function (estimated glomerular filtration rate [eGFR]) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Individuals with 2 measures of eGFRResults: The study population consisted of 460,737 people (n=245,573 [53.30%] female, mean age 47.4 years) who were Tasmanian residents aged 18 years and older and were followed for a median of 7.8 years. During the later 5 years of the study period, 86.79% (355,622/409,729) of Tasmanian adults were represented. The CKD cohort consisted of 56,438 people (ie, 12.25% of the study population; 53.87% (30,405/56,438) female, mean age 69.9 years) followed for a median of 10.4 years with 56,039 detected via eGFR and 399 people detected via documentation of KRT. Approximately half (227,433/460,737, 49.36%) of the study population and the majority of the CKD cohort (41,448/56,438, 73.44%) had an admission episode. Of the 55,366 deaths recorded in the study population, 45.10% (24,970/55,366) had CKD.Conclusions: Whole-of-population approaches to examine CKD in the community can be achieved by data linkage. Over this 14-year period, CKD affected 12.25% (56,438/460,737) of Tasmanian adult residents and was present in 45.10% (24,970/55,366) of deaths.

Item Type:	Article
Authors/Creators:	Saunder, T and Kitsos, A and Radford, J and Jose, K and McKercher, C and Raj, R and Wiggins, N and Stokes, B and Jose, MD
Keywords:	chronic kidney disease, dialysis, end-stage kidney disease, transplantation
Journal or Publication Title:	JMIR Research Protocols
Publisher:	J M I R Publications, Inc.
ISSN:	1929-0748
DOI / ID Number:	10.2196/20160
Copyright Information:	©Timothy Saunder, Alex Kitsos, Jan Radford, Kim Jose, Charlotte McKercher, Rajesh Raj, Nadine Wiggins, Brian Stokes, Matthew D Jose. Originally published in JMIR Research Protocols http://www.researchprotocols.org), 17.09.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
Related URLs:	Google Scholar: Kitsos, A UTAS Profile: Kitsos, A Google Scholar: Radford, J UTAS Profile: Radford, J Google Scholar: Jose, K UTAS Profile: Jose, K Google Scholar: McKercher, C Google Scholar: Jose, MD UTAS Profile: Jose, MD
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