title: The profile of patients with chronic kidney disease who regularly present at an Australian general practice.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a common, serious and mostly asymptomatic condition that places considerable burden on the Australian healthcare system. Yet there is limited information on the patients with CKD who present to Australian primary care services, which represent the gateway to specialized care.
  
  
  METHODS
  Data pertaining to 31,897 patients who presented to a general practice in Western Australia, from 1 January 2013 to 30 June 2014 (inclusive), were extracted for review. Data included attendance records, comorbidities, diagnoses, and demographic details. Binary logistic regression was used to compare patients diagnosed with CKD by the consulting general practitioner with those without this diagnosis.
  
  
  RESULTS
  Of the 8629 patients who regularly attended the practice, 184 (2%) were diagnosed with CKD (mean age: 77.7 years; male: 57.1%). The stage of CKD was recorded in only 8.4% of cases. Patients with CKD averaged 11 more consultations in the past 18 months (mean difference 10.8, 95% CI [9.3, 12.3], p < .001). They were also more likely to: be male; be ex-smokers; be widowed; and to have a carer. Their most common comorbidities included acute infections, cerebrovascular or ischemic heart disease, osteopenia or osteoporosis, and cancer; 8.7% had died within the previous year.
  
  
  CONCLUSIONS
  Despite the prevalence of CKD, only one in five cases were recorded within this large practice. This reveals lost opportunities to monitor and manage patients with this chronic and common disease. Although this represents an important finding, this study is limited by the reliance on practice records, some of which were incomplete. Nevertheless, this study reveals two key findings. First, this disease is under-diagnosed and/or under-recorded. Second, patients with CKD have other, potentially unrelated, problems that may warrant attention.
authors.affiliation: a a Melbourne Clinical School , School of Medicine Sydney University of Notre Dame , Werribee, VIC , Australia.
authors.forename: Moyez
authors.initials: M
authors.lastname: Jiwa
authors.affiliation: b b Renal Medicine, Sir Charles Gairdner Hospital , Perth, WA , Australia.
authors.forename: Aron
authors.initials: A
authors.lastname: Chakera
authors.affiliation: c c School of Business , Western Sydney University , Parramatta, NSW , Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Dadich
authors.affiliation: d d School of Medicine , Flinders University , Adelaide, SA , Australia.
authors.forename: Xingqiong
authors.initials: X
authors.lastname: Meng
authors.affiliation: a a Melbourne Clinical School , School of Medicine Sydney University of Notre Dame , Werribee, VIC , Australia.
authors.forename: Epi
authors.initials: E
authors.lastname: Kanjo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D005260:Female; D058006:General Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000628:therapy*
keywords: Chronic kidney disease; Consultation; General practice; Nephrology; Population characteristics; Primary care