title: Factors associated with chronic kidney disease progression in Australian nephrology practices.
abstract: OBJECTIVE
  Chronic kidney disease (CKD) is a major health issue worldwide. The aim of this study was to explore factors associated with CKD progression in Australian nephrology practices.
  
  
  METHODS
  This was a retrospective study utilising an electronic medical record (EMR), Audit4 (Software for Specialists, Australia). The baseline visit was defined as the first entry into the EMR. The primary outcome was the rate of change in estimated glomerular filtration rate (eGFR).
  
  
  RESULTS
  1,328 patients were included with a mean eGFR at baseline of 37.4 ± 0.7 ml/min/1.73 m(2), a mean follow-up of 17.7 months and a mean annual rate of change in eGFR of -0.84 ± 0.26 ml/min/1.73 m(2). Univariate analysis demonstrated that women, smokers, and patients prescribed erythropoiesis-stimulating agents (ESA) had a significantly more rapid decline in eGFR (p = 0.007, 0.033, and 0.003, respectively). On multivariate analysis: gender, age, prescription of ESA and phosphate binders, and baseline eGFR were significantly associated with CKD progression (p = 0.003, 0.004, <0.001, 0.029, and <0.001, respectively).
  
  
  CONCLUSIONS
  This study identifies potential factors associated with CKD progression in a population referred to nephrologists, but current data quality may result in bias. Implementation of changes in the format of data collection is required so that busy clinicians record essential information to enable this to become a more accurate and reliable research tool.
authors.affiliation: Sir Charles Gairdner Hospital, Perth, WA, Australia. neil.boudville@uwa.edu.au
authors.forename: Neil
authors.initials: N
authors.lastname: Boudville
authors.forename: Anna
authors.initials: A
authors.lastname: Kemp
authors.forename: Henry
authors.initials: H
authors.lastname: Moody
authors.forename: Robert G
authors.initials: RG
authors.lastname: Fassett
authors.forename: Eugenie
authors.initials: E
authors.lastname: Pedagogos
authors.forename: Craig
authors.initials: C
authors.lastname: Nelson
authors.forename: Helen
authors.initials: H
authors.lastname: Healy
authors.forename: George
authors.initials: G
authors.lastname: Mangos
authors.forename: Geoff
authors.initials: G
authors.lastname: Kirkland
authors.forename: Troy
authors.initials: T
authors.lastname: Kay
authors.forename: Paul
authors.initials: P
authors.lastname: Champion de Crespigny
authors.forename: David
authors.initials: D
authors.lastname: Hoffman
authors.forename: David
authors.initials: D
authors.lastname: Waugh
mesh_terms: D000367:Age Factors; D000368:Aged; D001315:Australia; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009398:Nephrology; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D006397:Hematinics