{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:57:30Z","timestamp":1793325450176,"version":"4.5.0"},"reference-count":22,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe chronic kidney disease (CKD) regarding treatment rates, comorbidities, usage of CKD International Classification of Diseases (ICD) diagnosis, mortality, hospitalisation, evaluate healthcare utilisation and screening for CKD in relation to new nationwide CKD guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population-based observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Healthcare registry data of patients in Southwest Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>A total cohort of 65\u2009959 individuals aged &gt;18 years of which 20\u2009488 met the criteria for CKD (cohort 1) and 45\u2009470 at risk of CKD (cohort 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Data were analysed with regards to prevalence, screening rates of blood pressure, glucose, estimated glomerular filtration rate (eGFR), Urinary\u2013albumin\u2013creatinine ratio (UACR) and usage of ICD-codes for CKD. Mortality and hospitalisation were analysed with logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the CKD cohort, 18% had CKD ICD-diagnosis and were followed annually for blood pressure (79%), glucose testing (76%), eGFR (65%), UACR (24%). UACR follow-up was two times as common in hypertensive and cardiovascular versus diabetes patients with CKD with a similar pattern in those at risk of CKD. Statin and renin\u2013angiotensin\u2013aldosterone inhibitor appeared in 34% and 43%, respectively. Mortality OR at CKD stage 5 was 1.23 (CI 0.68 to 0.87), diabetes 1.20 (CI 1.04 to 1.38), hypertension 1.63 (CI 1.42 to 1.88), atherosclerotic cardiovascular disease (ASCVD) 1.84 (CI 1.62 to 2.09) associated with highest mortality risk. Hospitalisation OR in CKD stage 5 was 1.96 (CI 1.40 to 2.76), diabetes 1.15 (CI 1.06 to 1.25), hypertension 1.23 (CI 1.13 to 1.33) and ASCVD 1.52 (CI 1.41 to 1.64).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The gap between patients with CKD by definition versus those diagnosed as such was large. Compared with recommendations patients with CKD have suboptimal follow-up and treatment with renin\u2013angiotensin\u2013aldosterone system inhibitor and statins. Hypertension, diabetes and ASCVD were associated with increased mortality and hospitalisation. Improved screening and diagnosis of CKD, identification and management of risk factors and kidney protective treatment could affect clinical and economic outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2022-069313","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T17:37:01Z","timestamp":1689961021000},"page":"e069313","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Characteristics, management and outcomes in patients with CKD in a healthcare region in Sweden: a population-based, observational study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3956-6103","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Agvall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5688-0156","authenticated-orcid":false,"given":"Awais","family":"Ashfaq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Bjurstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2006-6229","authenticated-orcid":false,"given":"Kobra","family":"Etminani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovisa","family":"Friberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Lid\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-0341","authenticated-orcid":false,"given":"Markus","family":"Lingman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"2023072110351020000_13.7.e069313.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30045-3"},{"key":"2023072110351020000_13.7.e069313.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.06.017"},{"key":"2023072110351020000_13.7.e069313.3","doi-asserted-by":"publisher","DOI":"10.1159\/000455197"},{"key":"2023072110351020000_13.7.e069313.4","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.73"},{"key":"2023072110351020000_13.7.e069313.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.10.012"},{"key":"2023072110351020000_13.7.e069313.6","unstructured":"Nationellt v\u00e5rdprogram f\u00f6r kronisk njursjukdom . Nationellt Programomr\u00e5de (NPO) F\u00f6r Njur \u2013 och Urinv\u00e4gssjukdomar. 2021. 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Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2\u00b74 million patients from 11 countries: the Careme CKD study. 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