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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Challenges of conducting kidney health checks among patients at risk of chronic kidney disease and attending an urban Aboriginal and Torres Strait Islander primary healthcare service

Prabha Lakhan A B * , Anna Cooney A , Dharmenaan Palamuthusingam C , Gary Torrens D , Geoffrey Spurling A E , Antonio Martinez F and David Johnson G H I
+ Author Affiliations
- Author Affiliations

A Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, Inala, Qld 4077, Australia.

B The University of Queensland, Poche Centre for Indigenous Health, Brisbane, Qld 4067, Australia.

C Metro North Kidney Health Service, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia.

D Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia.

E The University of Queensland, Primary Care Clinical Unit, Level 8, Health Sciences Building, Building 16/910, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia.

F Mount Isa Hospital, 30 Camooweal Street, Mount Isa, Qld 4825, Australia.

G Department of Nephrology, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia.

H Centre for Kidney Disease Research, University of Queensland, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia.

I Translational Research Institute, 199 Ipswich Road, Woolloongabba, Qld 4102, Australia.

* Correspondence to: prabha.lakhan@health.qld.gov.au

Australian Journal of Primary Health 28(5) 371-379 https://doi.org/10.1071/PY21248
Submitted: 28 October 2021  Accepted: 14 February 2022   Published: 22 July 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University.

Abstract

Background: The increasing incidence of chronic kidney disease (CKD) globally highlights the importance of early targeted screening of at-risk persons in primary healthcare settings. This study investigated the early detection of CKD among Aboriginal and Torres Strait Islander patients attending an urban primary healthcare service.

Methods: Routine data extracted for all patients with an active electronic medical record on 7 December 2017 were used to identify patients who were eligible to have a kidney health check (KHC), comprising estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR) tests. A subsequent manual search of electronic health records identified the presence of CKD risk factors and follow-up KHCs.

Results: Of the 1181 eligible patients, 171 (15%) had a complete initial KHC. Of the eight patients with an initial abnormal eGFR, two (25%) had a repeat eGFR assessment within 3 months to confirm the presence of CKD. Of the 30 patients who had an initial abnormal UACR result, three (10%) had at least one repeat UACR measurement within 3 months. In patients with diabetes and/or hypertension and a normal initial KHC, 51% had a repeat eGFR and 36% had UACR within the recommended time frame of 12 months. Similar findings were observed for the recommended time frame of 24 months in patients without diabetes or hypertension.

Conclusion: Accurate documentation of risk factors for CKD and processes to address the barriers to implementation of Kidney Health Australia guidelines will assist in preventing or delaying progression of CKD.

Keywords: chronic kidney disease, early detection, primary health care.


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