National primary care guidelines for England: impact on chronic kidney disease prevention in South Asian populations
National primary care guidelines for England: impact on chronic kidney disease prevention in South Asian populations
J Nephrol 2012; 25(5): 661 - 671
DOI:10.5301/jn.5000037
Authors
Emma Wilkinson, Gurch Randhawa, Paul Roderick, Tariq Rehman, Talib Abubacker
Abstract
Introduction: This study evaluated the impact of national policy for kidney disease in primary care comparing South Asian (SA) and white European (WE) population groups. Methods: Retrospective audits of primary care records of SA and WE adults diagnosed with diabetes in 2004 and 2007 were carried out in a total sample of 707 patients across 18 general practices within Luton, Leicester and West London. Results: Four hundred patients (SA: n=241, and WE: n=159) were diagnosed as diabetic in 2004, and 307 (SA: n=178, and WE: n=129) in 2007. South Asian patients were 9-10 years younger, had lower systolic blood pressure than white Europeans at diagnosis in both years (136.1 vs. 141.4 mm Hg, p=0.01, in 2004; and 134 vs. 142.3 mm Hg, p=0.000, in 2007) and significantly higher HbA1c (8.6%, 63 mmol/L vs. 7.9%, 71 mmol/L) at diagnosis in 2004 than in 2007 (8.3%, 67 mmol/L vs. 8.2%, 66 mmol/L). Recording of the majority of variables associated with diabetic kidney disease increased across both patient groups between 2004 and 2007: albumin to creatinine ratio (up 13.0% in SA to 37.9%, and 15.1% in WE to 40.3%), estimated glomerular filtration rate (up 61.7% in SA to 70.8% and 75.6% in WE to 80.6%) and proteinuria (up 19.3% in SA to 46.3% and 26.1% in WE to 51.9%). Conclusions: Recording of indicators for diabetic kidney disease at diagnosis increased in both South Asians and white Europeans following introduction of national guidance to improve early detection and quality of care in the diabetic kidney disease care pathway.
Article History
- • Accepted on 8/31/2011
- • Available online on 10/7/2011
- • Published in print on 9/20/2012
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Authors
- Wilkinson, Emma
[PubMed]
[Google Scholar]
University of Bedfordshire, Luton - UK University of Bedfordshire, Luton - UK
- Randhawa, Gurch
[PubMed]
[Google Scholar]
University of Bedfordshire, Luton - UK University of Bedfordshire, Luton - UK
- Roderick, Paul
[PubMed]
[Google Scholar]
University of Southampton, Southampton - UK
- Rehman, Tariq
[PubMed]
[Google Scholar]
Luton and Dunstable Hospital NHS Foundation Trust, Luton - UK
- Abubacker, Talib
[PubMed]
[Google Scholar]
Bell House Medical Centre, Luton - UK
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