{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:46Z","timestamp":1772168926667,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.20229.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000}}],"reference-count":30,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["RP-PG-1210-12003"],"award-info":[{"award-number":["RP-PG-1210-12003"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013373","name":"NIHR Oxford Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013373","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Evidence for kidney function monitoring intervals in primary care is weak, and based mainly on expert opinion. In the absence of trials of monitoring strategies, an approach combining a model for the natural history of kidney function over time combined with a cost-effectiveness analysis offers the most feasible approach for comparing the effects of monitoring under a variety of policies. This study aimed to create a model for kidney disease progression using routinely collected measures of kidney function.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    This is an open cohort study of patients aged \u226518 years, registered at 643 UK general practices contributing to the Clinical Practice Research Datalink between 1 April 2005 and 31 March 2014. At study entry, no patients were kidney transplant donors or recipients, pregnant or on dialysis. Hidden Markov models for estimated glomerular filtration rate (eGFR) stage progression were fitted to four patient cohorts defined by baseline albuminuria stage; adjusted for sex, history of heart failure, cancer, hypertension and diabetes, annually updated for age.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Of 1,973,068 patients, 1,921,949 had no recorded urine albumin at baseline, 37,947 had normoalbuminuria (&lt;3mg\/mmol), 10,248 had microalbuminuria (3\u201330mg\/mmol), and 2,924 had macroalbuminuria (&gt;30mg\/mmol). Estimated annual transition probabilities were 0.75\u20131.3%, 1.5\u20132.5%, 3.4\u20135.4% and 3.1\u201311.9% for each cohort, respectively. Misclassification of eGFR stage was estimated to occur in 12.1% (95%CI: 11.9\u201312.2%) to 14.7% (95%CI: 14.1\u201315.3%) of tests. Male gender, cancer, heart failure and age were independently associated with declining renal function, whereas the impact of raised blood pressure and glucose on renal function was entirely predicted by albuminuria.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    True kidney function deteriorates slowly over time, declining more sharply with elevated urine albumin, increasing age, heart failure, cancer and male gender. Consecutive eGFR measurements should be interpreted with caution as observed improvement or deterioration may be due to misclassification.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.20229.2","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T11:40:05Z","timestamp":1659958805000},"page":"1618","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Statistical models for the deterioration of kidney function in a primary care population: A retrospective database analysis"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3467-6677","authenticated-orcid":false,"given":"Jason L","family":"Oke","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3928-6750","authenticated-orcid":false,"given":"Benjamin 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One."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T06:00:28Z","timestamp":1664863228000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,8]]},"references-count":30,"URL":"https:\/\/doi.org\/10.12688\/f1000research.20229.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.136788.r146904","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.136788.r146903","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.136788.r146903","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.136788.r146904","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,8]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.136788.r146904, Dorothea Nitsch, Department of Non-Communicable Disease Epidemiology, London School of Hygiene\u00a0and\u00a0Tropical Medicine\u00a0(LSHTM), London, UK, 23 Aug 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2#referee-response-146904","order":0,"name":"referee-response-146904","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.136788.r146903, Lawrence Hunsicker, Department of Internal Medicine, University of Iowa, Iowa City, USA, 04 Oct 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/8-1618\/v2#referee-response-146903","order":1,"name":"referee-response-146903","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme [Reference: RP-PG-1210-12003]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.\n\nRP, FDRH and BM receive funding from the NIHR Oxford Biomedical Research Council (BRC). RP and FDRH receive funding from the NIHR Collaboration for Leadership in Health Research and Care (CLARHC) Oxford and the NIHR Oxford Medtech and In-Vitro Diagnostics Co-operative (MIC). RP receives funding from  the NIHR Health Protection Research Unit Gastrointestinal Infections Group.  FDRH receives funding from the NIHR School for Primary Care Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}