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Background and objectives: The majority of patients with chronic kidney disease (1) stage 3 are managed in non-specialist centres but most studies of CKD are conducted in Nephrology Departments in secondary care. Moreover, subjects ~75 years, which make up a large proportion, are often excluded. We undertook a detailed prospective study of unselected patients in primary care to fill the knowledge gap regarding CKD stage 3 and to identify factors that may be independent determinants of cardiovascular disease (CVO) and progressive CKD in this setting. Design, setting, participants and measurements: Subjects with eGFR 59- 30mUmin/1.73m2 were recruited from 32 Primary Care Practices. Medical history and demographic data were obtained and participants underwent clinical assessment including blood pressure, anthropomorphic measurements, skin autofluorescence (AF) and pulse wave velocity (PWV) as well as extensive urine and serum biochemistry. Results: 1741 participants were included: mean age 72.9±9 yrs; 60% (n=1052) female; 97.5% (n=1698) white; 17% (n=294) diabetic. Mean eGFR was 52.5±10mLs/min/1. 73m2 and 16.9% had microalbuminuria or more severe proteinuria. 77% had CKD stage 3A and 64.5% (n=1123) received RAASi treatment. 22.2% (n=387) had a history of cardiovascular events and 55% (n=950) were past or current smokers. Analysis identified participants with CKD stage 38, diabetes and age "275 years evidencing a higher risk profile for CKD progression and cardiovascular events than people with CKD stage 3A, those without diabetes or participants |
