Description and Cross-Sectional Analyses of 25,880 Adults and Children in the UK National Registry of Rare Kidney Diseases Cohort (2024)

Type of publication:

Journal article

Author(s):

Wong K.; Pitcher D.; Braddon F.; Downward L.; Steenkamp R.; Masoud S.; Annear N.; Barratt J.; Bingham C.; Coward R.J.; Chrysochou T.; Game D.; Griffin S.; Hall M.; Johnson S.; Kanigicherla D.; Karet Frankl F.; Kavanagh D.; Kerecuk L.; Maher E.R.; Moochhala S.; Sayer J.A.; Simms R.; Sinha S.; Srivastava S.; Tam F.W.K.; Thomas K.; Turner A.N.; Walsh S.B.; Waters A.; Wilson P.; Wong E.; Sy K.T.L.; Huang K.; Ye J.; Nitsch D.; Saleem M.; Bockenhauer D.; Bramham K.; Gale D.P.; Abat S.; Adalat S.; Agbonmwandolor J.; Ahmad Z.; Alejmi A.; Almasarwah R.; Asgari E.; Ayers A.; Baharani J.; Balasubramaniam G.; Kpodo F.J.-B.; Bansal T.; Barratt A.; Bates M.; Bayne N.; Bendle J.; Benyon S.; Bergmann C.; Bhandari S.; Boddana P.; Bond S.; Branson A.; Brearey S.; Brocklebank V.; Budwal S.; Byrne C.; Cairns H.; Camilleri B.; Campbell G.; Capell A.; Carmody M.; Carson M.; Cathcart T.; Catley C.; Cesar K.; Chan M.; Chea H.; Chess J.; Cheung C.K.; Chick K.-J.; Chitalia N.; Christian M.; Clark K.; Clayton C.; Clissold R.; Cockerill H.; Coelho J.; Colby E.; Colclough V.; Conway E.; Cook H.T.; Cook W.; Cooper T.; Crosbie S.; Cserep G.; Date A.; Davidson K.; Davies A.; Dhaun N.; Dhaygude A.; Diskin L.; Dixit A.; Doctolero E.A.; Dorey S.; Downard L.; Drayson M.; Dreyer G.; Dutt T.; Etuk K.; Evans D.; Finch J.; Flinter F.; Fotheringham J.; Francis L.; Gallagher H.; Garcia E.L.; Gavrila M.; Gear S.; Geddes C.; Gilchrist M.; Gittus M.; Goggolidou P.; Goldsmith C.; Gooden P.; Goodlife A.; Goodwin P.; Grammatikopoulos T.; Gray B.; Griffith M.; Gumus S.; Gupta S.; Hamilton P.; Harper L.; Harris T.; Haskell L.; Hayward S.; Hegde S.; Hendry B.; Hewins S.; Hewitson N.; Hillman K.; Hiremath M.; Howson A.; Htet Z.; Huish S.; Hull R.; Humphries A.; Hunt D.P.J.; Hunter K.; Hunter S.; Ijeomah-Orji M.; Inston N.; Jayne D.; Jenfa G.; Jenkins A.; Jones C.A.; Jones C.; Jones A.; Jones R.; Kamesh L.; Frankl F.K.; Karim M.; Kaur A.; Kearley K.; Khwaja A.; King G.; Kislowska E.; Klata E.; Kokocinska M.; Lambie M.; Lawless L.; Ledson T.; Lennon R.; Levine A.P.; Maggie Lai L.W.; Lipkin G.; Lovitt G.; Lyons P.; Mabillard H.; Mackintosh K.; Mahdi K.; Maher E.; Marchbank K.J.; Mark P.B.; Masunda B.; Mavani Z.; Mayfair J.; McAdoo S.; Mckinnell J.; Melhem N.; Meyrick S.; Morgan P.; Morgan A.; Muhammad F.; Murray S.; Novobritskaya K.; Ong A.C.; Oni L.; Osmaston K.; Padmanabhan N.; Parkes S.; Patrick J.; Pattison J.; Paul R.; Percival R.; Perkins S.J.; Persu A.; Petchey W.G.; Pickering M.C.; Pinney J.; Plumb L.; Plummer Z.; Popoola J.; Post F.; Power A.; Pratt G.; Pusey C.; Rabara R.; Rabuya M.; Raju T.; Javier C.; Roberts I.S.; Roufosse C.; Rumjon A.; Salama A.; Sandford R.N.; *Sandu K.S.; Sarween N.; Sebire N.; Selvaskandan H.; Shah S.; Sharma A.; Sharples E.J.; Sheerin N.; Shetty H.; Shroff R.; Sinha M.; Smith K.; Smith L.; Stott I.; Stroud K.; Swift P.; Szklarzewicz J.; Tam F.; Tan K.; Taylor R.; Tischkowitz M.; Tse Y.; Turnbull A.; Tyerman K.; Usher M.; Venkat-Raman G.; Walker A.; Watt A.; Webster P.; Wechalekar A.; Welsh G.I.; West N.; Wheeler D.; Wiles K.; Willcocks L.; Williams A.; Williams E.; Williams K.; Wilson D.H.; Wilson P.D.; Winyard P.; Wood G.; Woodward E.; Woodward L.; Woolf A.; Wright D.;

Citation:

Kidney International Reports. 9(7) (pp 2067-2083), 2024. Date of Publication: 01 Jul 2024.

Abstract:

Introduction: The National Registry of Rare Kidney Diseases (RaDaR) collects data from people living with rare kidney diseases across the UK, and is the world's largest, rare kidney disease registry. We present the clinical demographics and renal function of 25,880 prevalent patients and sought evidence of bias in recruitment to RaDaR.

Method(s): RaDaR is linked with the UK Renal Registry (UKRR, with which all UK patients receiving kidney replacement therapy [KRT] are registered). We assessed ethnicity and socioeconomic status in the following: (i) prevalent RaDaR patients receiving KRT compared with patients with eligible rare disease diagnoses receiving KRT in the UKRR, (ii) patients recruited to RaDaR compared with all eligible unrecruited patients at 2 renal centers, and (iii) the age-stratified ethnicity distribution of RaDaR patients with autosomal dominant polycystic kidney disease (ADPKD) was compared to that of the English census.

Result(s): We found evidence of disparities in ethnicity and social deprivation in recruitment to RaDaR; however, these were not consistent across comparisons. Compared with either adults recruited to RaDaR or the English population, children recruited to RaDaR were more likely to be of Asian ethnicity (17.3% vs. 7.5%, P-value < 0.0001) and live in more socially deprived areas (30.3% vs. 17.3% in the most deprived Index of Multiple Deprivation (IMD) quintile, P-value < 0.0001).

Conclusion(s): We observed no evidence of systematic biases in recruitment of patients into RaDaR; however, the data provide empirical evidence of negative economic and social consequences (across all ethnicities) experienced by families with children affected by rare kidney diseases.

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Each Baby Counts: Learn and Support (2024)

Type of publication:

Service improvement case study

Author(s):

*Paula Pryce

Citation:

SaTH Improvement Hub, September 2024

SMART Aim:

To introduce the communication tool and terminology of Each Baby Counts: Learn and Support to the team by the end of August 2024 as evidenced by observation of conversations and documentation.

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Medical Acute Take Handover (2024)

Type of publication:

Service improvement case study

Author(s):

*Navya Basavaraju, *Dr Sam Craik, *Hazel Green, *Dr Nawaid Ahmad, *Dr Shakawan Ismaeel, * Dr Thimmegowda Govindagowda

Citation:

SaTH Improvement Hub, September 2024

SMART Aim:

Improve how colleagues feel about the content and structure of a Medical Acute Take Handover by 1st September 2024. To improve the structure and standardization of handover at our hospital in concordance with Royal College of Physicians (RCP) recommendations for good clinical handover

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PRH ED Waiting Room Improvements (2024)

Type of publication:

Service improvement case study

Author(s):

*Laura Wild

Citation:

SaTH Improvement Hub, August 2024

SMART Aim:

Improve the quality of care provided to patients as measured by an increase in compliance to observations, analgesia provision, reduction in interruptions and improvement in patient feedback by 31/07/2024.

Link to PDF poster

SATH Children’s Assessment Unit Improvement Programme (2024)

Type of publication:

Service improvement case study

Author(s):

*Rachel Triggs

Citation:

SaTH Improvement Hub, October 2024

SMART Aim:

To facilitate a core group of Registered children's nurses who work in the Children’s Assessment Unit (CAU) to become competent in conducting a Triage on all paediatric patients referred to the unit using the Manchester Triage system.

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AMA Seated Area Test of Change (2024)

Type of publication:

Service improvement case study

Author(s):

*Rebekah Tudor

Citation:

SaTH Improvement Hub, November 2024

SMART Aim:

  • Improve the Length of stay (LoS) in the RSH Emergency Department (for medical patients) during the test of change weeks (by 25/10/2024)
  • Improve the LoS in the AMA Seated Area at RSH during the test of change weeks (by 25/10/2024)
  • Improve the number of discharges (all discharge destinations) from the RSH acute floor during the test of change weeks (by 25/10/2024)

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Mucus plugging and mucolytics in patients admitted with acute exacerbation of chronic obstructive pulmonary disease (COPD); investigating impact on short term mortality (2024)

Type of publication:

Conference abstract

Author(s):

*Abugassa E.; *Bosher O.; *Makan N.; *Crawford E.; *Saleem M.A.; *Srinivasan K.; *Moudgil H.

Citation:

European Respiratory Journal. Conference: European Respiratory Society International Congress, ERS 2024. Vienna Austria. 64(Supplement 68) (pp PA3010), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Background: Although mucus plugging occluding medium to large sized airways in COPD is associated with increased long term all-cause mortality, acute exacerbations require further investigation, particularly where, despite reducing morbidity and improving quality of life, long-term use of mucolytics remains controversial. Objectives were (1) to quantify chest CT evidence of mucus plugging, (2) relate findings to mucolytics, and (3) investigate mucus plugging association with short term mortality.

Method(s): Retrospective review of 100 patients admitted with exacerbation of COPD (105 admissions).comparative analysis by chi square (x2) and logistic regression, significant p<.05.

Result(s): Mean (SD, range) age was 74.7 (10.5, 41-97) years with 54% male; mean FEV1/FVC 55% with FEV1 1.2(0.59, 0.4-3.6) litres at 49% predicted. 23 were on long term oxygen (LTOT). Mean stay was 6.3 (1-41) days. 24 died in the first 6 months. Where a historical or admission chest CT was available (n=82), 12 (15%) had mucus plugging with mucolytics prescribed to 6 (50%) compared to 32/70 (46%) without plugging (x2 0.057, NS). 9/56 (16%) with mucus plugging vs 3/26 (12%) without (x2 0.2921, NS) had emphysema and 3/13 (23%) vs 9/69 (13%) without (x2 1.016, NS) bronchiectasis. Regression investigating mortality at 6 months showed adverse outcomes for male sex, lower FEV1, and LTOT.

Conclusion(s): 15% with acute COPD admissions have current or historical evidence of mucus plugging. Mucolytics are prescribed for 45% irrespective of prior CT radiology. Mortality (24%) at 6 months is high but not shown related to mucus plugging or reduced by mucolytics.

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