Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019
Chronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis an...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182 |
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| author | Valdemir Kim Gulnur Zhakhina Arnur Gusmanov Yesbolat Sakko Mariyam Kim Meruyert Madikenova Zhannat Kuanshaliyeva Alpamys Issanov Ainur Assan Marina Khvan Altay Nabiyev Sholpan Altynova Abduzhappar Gaipov |
| author_facet | Valdemir Kim Gulnur Zhakhina Arnur Gusmanov Yesbolat Sakko Mariyam Kim Meruyert Madikenova Zhannat Kuanshaliyeva Alpamys Issanov Ainur Assan Marina Khvan Altay Nabiyev Sholpan Altynova Abduzhappar Gaipov |
| author_sort | Valdemir Kim |
| collection | DOAJ |
| description | Chronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis and survival post-RRT initiation in Kazakhstan remain limited. This study aims to investigate the impact of late CKD diagnosis on survival prognosis after RRT initiation. Data were acquired from the Unified National Electronic Health System (UNEHS) for CKD patients initiating RRT between 2014 and 2019. Survival post-RRT initiation was assessed using the Cox Proportional Hazards Model. Totally, 211,655 CKD patients were registered in the UNEHS databases and 9,097 (4.3%) needed RRT. The most prevalent age group among RRT patients is 45–64 years, with a higher proportion of males (56%) and Kazakh ethnicity (64%). Seventy-four percent of patients were diagnosed late. The median follow-up time was 537 (IQR: 166–1101) days. Late diagnosis correlated with worse survival (HR = 1.18, p < 0.001). Common comorbidities among RRT patients include hypertension (47%), diabetes (21%), and cardiovascular diseases (26%). The history of transplantation significantly influenced survival. Regional disparities in survival probabilities were observed, highlighting the need for collaborative efforts in healthcare delivery. This study underscores the substantial burden of CKD in Kazakhstan, with a majority of patients diagnosed late. Early detection strategies and timely kidney transplantation emerge as crucial interventions to enhance survival outcomes. |
| format | Article |
| id | doaj-art-55c744ce77ff484c9513d4d84ba959d2 |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-55c744ce77ff484c9513d4d84ba959d22025-08-20T02:38:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2398182Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019Valdemir Kim0Gulnur Zhakhina1Arnur Gusmanov2Yesbolat Sakko3Mariyam Kim4Meruyert Madikenova5Zhannat Kuanshaliyeva6Alpamys Issanov7Ainur Assan8Marina Khvan9Altay Nabiyev10Sholpan Altynova11Abduzhappar Gaipov12Department of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanClinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, KazakhstanSchool of Population and Public Health, University of British Columbia, Vancouver, CanadaDepartment of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanClinical Academic Department of Internal Medicine, CF “University Medical Center”, Astana, KazakhstanDepartment of Medical and Regulatory Affairs, CF “University Medical Center”, Astana, KazakhstanDepartment of Medicine, School of Medicine, Nazarbayev University, Astana, KazakhstanChronic kidney disease (CKD) presents a significant global health challenge, often progressing to end-stage renal disease (ESRD) necessitating renal replacement therapy (RRT). Late referral (LR) to nephrologists before RRT initiation is linked with adverse outcomes. However, data on CKD diagnosis and survival post-RRT initiation in Kazakhstan remain limited. This study aims to investigate the impact of late CKD diagnosis on survival prognosis after RRT initiation. Data were acquired from the Unified National Electronic Health System (UNEHS) for CKD patients initiating RRT between 2014 and 2019. Survival post-RRT initiation was assessed using the Cox Proportional Hazards Model. Totally, 211,655 CKD patients were registered in the UNEHS databases and 9,097 (4.3%) needed RRT. The most prevalent age group among RRT patients is 45–64 years, with a higher proportion of males (56%) and Kazakh ethnicity (64%). Seventy-four percent of patients were diagnosed late. The median follow-up time was 537 (IQR: 166–1101) days. Late diagnosis correlated with worse survival (HR = 1.18, p < 0.001). Common comorbidities among RRT patients include hypertension (47%), diabetes (21%), and cardiovascular diseases (26%). The history of transplantation significantly influenced survival. Regional disparities in survival probabilities were observed, highlighting the need for collaborative efforts in healthcare delivery. This study underscores the substantial burden of CKD in Kazakhstan, with a majority of patients diagnosed late. Early detection strategies and timely kidney transplantation emerge as crucial interventions to enhance survival outcomes.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182Chronic kidney diseaserenal replacement therapylate diagnosissurvival prognosisend-stage renal disease |
| spellingShingle | Valdemir Kim Gulnur Zhakhina Arnur Gusmanov Yesbolat Sakko Mariyam Kim Meruyert Madikenova Zhannat Kuanshaliyeva Alpamys Issanov Ainur Assan Marina Khvan Altay Nabiyev Sholpan Altynova Abduzhappar Gaipov Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 Renal Failure Chronic kidney disease renal replacement therapy late diagnosis survival prognosis end-stage renal disease |
| title | Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 |
| title_full | Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 |
| title_fullStr | Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 |
| title_full_unstemmed | Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 |
| title_short | Late diagnosis of CKD and associated survival after initiation of renal replacement therapy in Kazakhstan: analysis of nationwide electronic healthcare registry 2014–2019 |
| title_sort | late diagnosis of ckd and associated survival after initiation of renal replacement therapy in kazakhstan analysis of nationwide electronic healthcare registry 2014 2019 |
| topic | Chronic kidney disease renal replacement therapy late diagnosis survival prognosis end-stage renal disease |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2398182 |
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