title: National primary care guidelines for England: impact on chronic kidney disease prevention in South Asian populations.
abstract: BACKGROUND
  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.
authors: University of Bedfordshire, Luton, UK.
authors: Emma
authors: E
authors: Wilkinson
authors: Gurch
authors: G
authors: Randhawa
authors: Paul
authors: P
authors: Roderick
authors: Tariq
authors: T
authors: Rehman
authors: Talib
authors: T
authors: Abubacker
mesh_terms: D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control*; D042241:Early Diagnosis; D004739:England / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006291:Health Policy; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians'; D011314:Preventive Health Services / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D015397:Program Evaluation; D019984:Quality Indicators, Health Care / Q000592:standards; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control*; D012189:Retrospective Studies; D013222:State Medicine / Q000592:standards*; D044465:White People
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human