title: Chronic kidney disease in patients with diabetes mellitus type 2 or hypertension in general practice.
abstract: BACKGROUND
  The prevalence and severity of chronic kidney disease (CKD) in primary care patients with diabetes or hypertension is unknown.
  
  
  OBJECTIVE
  To assess the prevalence and severity of CKD in patients with diabetes and hypertension; and identify whether age, sex, diabetes, and hypertension are associated with CKD.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Two Dutch primary health care centres (15 954 enlisted patients).
  
  
  METHODS
  Patients, aged ≥ 25 years, with known diabetes type 2 (n = 471) or hypertension (n = 960), were selected on 1 October 2006. Initial screening uptake rates were assessed from the electronic patient records, and patients were invited when blood or urine measurements were missing. The presence of albuminuria was determined, glomerular filtration rate estimated, and clinical characteristics extracted.
  
  
  RESULTS
  Initial screening uptake rates were 93% and 69% for diabetes and hypertension, respectively, and increased to 97% (n = 455) and 87% (n = 836) after active invitation. The prevalence of CKD was 28% in diabetes and 21% in hypertension only. The presence of diabetes was independently associated with albuminuria (odds ratio [OR] 4.23; 95% confidence interval [CI] = 2.67 to 6.71), but not with decreased estimated GFR (eGFR) (OR 0.75; 95% CI = 0.54 to 1.04). Age showed the strongest association with decreased eGFR (OR 2.73; 95% CI = 2.02 to 3.70).
  
  
  CONCLUSIONS
  In primary care, more than one-quarter of patients with diabetes and about one-fifth of patients with hypertension have CKD. The high prevalence justifies longitudinal follow-up in order to evaluate whether intensified cardiovascular risk management is beneficial in this primary care population.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Centre and Academic Primary Health Care Centre 'Stevenshof', Leiden, The Netherlands. v.van_der_meer@lumc.nl
authors.forename: Victor
authors.initials: V
authors.lastname: van der Meer
authors.forename: H Petra M
authors.initials: HP
authors.lastname: Wielders
authors.forename: Diana C
authors.initials: DC
authors.lastname: Grootendorst
authors.forename: Joost S
authors.initials: JS
authors.lastname: de Kanter
authors.forename: Yvo Wj
authors.initials: YW
authors.lastname: Sijpkens
authors.forename: Willem Jj
authors.initials: WJ
authors.lastname: Assendelft
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.forename: Ymte
authors.initials: Y
authors.lastname: Groeneveld
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D058006:General Practice; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology