Epidemiology of chronic kidney disease in Australian general practice: National Prescribing Service MedicineWise MedicineInsight dataset

Aim To describe sociodemographic characteristics and comorbidities of a large cohort of Australian general practice-based patients identified as having chronic kidney disease (CKD), using data from National Prescribing Service (NPS) MedicineWise's MedicineInsight dataset, and compare this dataset to the 2011-2012 Australian Health Survey's (AHS) CKD prevalence estimates. Methods This was a cohort study using deidentified, longitudinal, electronic health record data collected from 329 practices and 1 483 416 patients distributed across Australia, from 1 June 2013 until 1 June 2016. Two methods were used to calculate the CKD prevalence. One used the same method as used by the 2011-2012 AHS, based on one estimate of the estimated glomerular filtration rate (eGFR) or albumin/creatinine ratios (ACR). The other defined CKD more rigorously using eGFR or ACR results at least 90 days apart. Results In 2016, of 1 310 602 active patients, 710 674 (54.2%) did not have an eGFR or ACR test, while 524 961 (40.1%) had an eGFR or ACR test but did not meet AHS criteria for CKD. Age-sex adjusted rates of CKD (compared to AHS) were CKD 1-0.45% (3.9%), CKD 2-0.62% (2.5%), CKD 3a: 3.1% (2.7%), CKD 3b: 1.14% (0.6%), CKD 4-5: 0.41% (0.3%). The CKD cohort defined more rigorously using eGFR and ACR measures >90 days apart, had comorbidities of atrial fibrillation (30.5%), cardiovascular disease (25.0%), diabetes mellitus (17.1%) and hypertension (14.8%). Conclusion The MedicineInsight dataset contains valuable and timely information about Australian patients with CKD, and provides prevalence estimates similar to those from AHS data.