Abstract
BackgroundAnonymous primary care records are an important resource for observational studies. However, their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We thus compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry.MethodsAmong all people ≥25 years of age registered in the CPRD for ≥1 year on 31 March 2014, we identified patients with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, according to their most recent serum creatinine in the past 5 years using the Chronic Kidney Disease Epidemiology Collaboration equation and patients with recorded diagnoses of RRT. Denominators were the entire population in each age–sex band irrespective of creatinine measurement. The prevalence of eGFR <60 mL/min/1.73 m2 was compared with that in the Health Survey for England (HSE) 2009/2010 and the prevalence of RRT was compared with that in the UK Renal Registry (UKRR) 2014.ResultsWe analysed 2 761 755 people in CPRD [mean age 53 (SD 17) years, men 49%], of whom 189 581 (6.86%) had an eGFR <60 mL/min/1.73 m2 and 3293 (0.12%) were on RRT. The prevalence of eGFR <60 mL/min/1.73 m2 in CPRD was similar to that in the HSE and the prevalence of RRT was close to that in the UKRR across all age groups in men and women, although the small number of younger patients with an eGFR <60 mL/min/1.73 m2 in the HSE might have hampered precise comparison.ConclusionsUK primary care data have good external validity for the prevalence of decreased kidney function and RRT.
Highlights
Anonymous primary care records are an important resource for observational studies
We examined the external validity of the prevalence of decreased kidney function
We examined the external validity of the prevalence of decreased kidney function and renal replacement therapy (RRT) in Clinical Practice Research Datalink (CPRD), by comparing them with results from two nationally representative sources (HSE and UK Renal Registry (UKRR))
Summary
Anonymous primary care records are an important resource for observational studies. Their external validity is unknown in identifying the prevalence of decreased kidney function and renal replacement therapy (RRT). We compared the prevalence of decreased kidney function and RRT in the Clinical Practice Research Datalink (CPRD) with a nationally representative survey and national registry. Chronic kidney disease (CKD) is a major public health problem, which increases in prevalence with age and is associated with increased morbidity and mortality [1,2,3]. The number of people with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT) has been increasing worldwide and is predicted to double by 2030 [4]. People who have kidney function measured routinely by serum creatinine may not represent the general population and serum creatinine assays may not be vi uniformly standardised
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