Establishing a high risk CKD cohort: cross-sectional analysis and early outcomes

Stringer, Stephanie Jane (2013). Establishing a high risk CKD cohort: cross-sectional analysis and early outcomes. University of Birmingham. Ph.D.

Preview

Stringer13PhD.pdf
PDF - Redacted Version
Download (4MB)

Abstract

Introduction
Patients with Chronic Kidney Disease (CKD) are at increased risk of both cardiovascular disease and progression to end-stage kidney disease; our understanding of the factors that determine these poor outcomes is incomplete. The study reported in this thesis has been designed to address some of these shortfalls.

Methods
I established a prospective, observational cohort study of patients with high risk CKD as defined by i) declining kidney function and/or ii) proteinuria and/or iii) advanced (stage 4 and 5) CKD. Participants undergo repeated detailed bio-clinical assessment over a follow up period of ten years and are tracked for clinical outcomes. The baseline data are presented in this thesis along with some data form the six-month visit.

Results
I report cross-sectional data from the first 500 participants; mean age is 65 years, 60% were male and 72% white ethnicity. Mean eGFR was 27mL/min/1.73m2 and median urine ACR was 26.9 mg/mmol. Detailed analyses demonstrated important associations between i) quality of life and unemployment, male gender, deprivation, co-morbidity and inflammation ii) arterial stiffness, inflammation and renal and cardiovascular outcomes iii) periodontitis and arterial stiffness iv) mortality, inflammation and arterial stiffness.

Conclusions
This thesis reports important new findings from patients with CKD and establishes a resource that will provide future insights that should contribute to improving clinical outcomes.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):