Hugh Gallagher

Hugh Gallagher
National Health Service | NHS · SW Thames Renal Unit

About

46
Publications
8,039
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1,650
Citations
Citations since 2017
9 Research Items
706 Citations
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2017201820192020202120222023020406080100120
2017201820192020202120222023020406080100120

Publications

Publications (46)
Article
Full-text available
Introduction Anemia is common in chronic kidney disease (CKD) and is associated with increased cardiovascular risk and reduced quality of life, but is often sub-optimally managed. Most patients are managed in primary care alongside other comorbidities. Interventions to improve the management of anemia in CKD in this setting are needed. Methods We...
Preprint
Background Anaemia is common in chronic kidney disease (CKD). It is associated with increased cardiovascular risk and reduced quality of life, but is often sub-optimally managed. Most patients are managed in primary care alongside other comorbidities. Interventions to improve the management of anaemia in CKD in this setting are needed. Methods We c...
Preprint
Full-text available
Background: Anaemia is common in chronic kidney disease (CKD). It is associated with increased cardiovascular risk and reduced quality of life, but is often sub-optimally managed. Most patients are managed in primary care alongside other comorbidities. Interventions to improve the management of anaemia in CKD in this setting are needed. Methods: W...
Article
Full-text available
This quality improvement project aimed to drive large scale and sustained change to reduce the burden of chronic kidney disease in the UK. The intervention is a software program that extracts relevant biochemical data from laboratory databases which then generate graphs of estimated kidney function (eGFR) over time. Graphs showing progressive kidne...
Article
Full-text available
Background: Accurately identifying cases of chronic kidney disease (CKD) from primary care data facilitates the management of patients, and is vital for surveillance and research purposes. Ontologies provide a systematic and transparent basis for clinical case definition and can be used to identify clinical codes relevant to all aspects of CKD car...
Article
Full-text available
People are living longer. On the whole, they have healthier lives and many of the problems previously seen at a younger age now appear in their later years. Kidneys, like other organs, age, and kidney disease in the aged is a prime example. In the United Kingdom, as in other developed countries, the prevalence of end stage kidney disease is highest...
Article
Full-text available
Background Patients who start renal replacement therapy (RRT) for End-Stage Kidney Disease (ESKD) without having had timely access to specialist renal services have poor outcomes. At one NHS Trust in England, a community-wide CKD management system has led to a decline in the incident rate of RRT and the lowest percentage of patients presenting with...
Article
Introduction: The ASSIST-CKD project is a national quality improvement programme, aiming to decrease the number of patients presenting late to renal services by enabling laboratories to review up to five years of estimated glomerular filtration rate (eGFR) results graphically, and report deteriorating patients to their general practitioner (GP)....
Article
Pregnancy outcomes in patients with end-stage renal disease (ESRD) on dialysis are improving. Recent literature supports intensive hemodialysis (HD) as the modality of choice during pregnancy in ESRD. We report the successful delivery of a healthy infant at full term in a patient with ESRD by supplementing peritoneal dialysis (PD) with intermittent...
Article
Full-text available
Objectives This study is a process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) study, comparing audit-based education (ABE) and sending clinical guidelines and prompts (G&P) with usual practice, in improving systolic blood pressure control in primary care. This evaluation aimed to explore how far clinical staff in partic...
Article
Diabetic Nephropathy affects 30-40% of people with diabetes, and is the leading cause of end stage kidney disease. The current treatment paradigm relies on early detection, glycaemic control and tight blood pressure management with preferential use of renin-angiotensin system blockade. This strategy has transformed outcomes in diabetic kidney disea...
Article
Full-text available
Chronic kidney disease (CKD) stages 3 to 5, affects 6–7% of the adult population and is an important risk factor for both advanced kidney disease and cardiovascular disease. This paper describes a quality improvement project that aimed to establish consistent implementation of best practice in people with stage 3–5 kidney disease who were managed i...
Article
Full-text available
Chronic kidney disease (CKD) is a known risk factor for cardiovascular events and all-cause mortality. We investigate the relationship between CKD stage, proteinuria, hypertension and these adverse outcomes in the people with diabetes. We also study the outcomes of people who did not have monitoring of renal function. A cohort of people with type 1...
Article
Full-text available
Serum phosphate is a known risk factor for cardiovascular events and mortality in people with chronic kidney disease (CKD), however data on the association of these outcomes with serum phosphate in the general population are scarce. We investigate this relationship in people with and without CKD in a large community-based population. Three groups f...
Article
Full-text available
Strict control of systolic blood pressure is known to slow progression of chronic kidney disease (CKD). Here we compared audit-based education (ABE) to guidelines and prompts or usual practice in lowering systolic blood pressure in people with CKD. This 2-year cluster randomized trial included 93 volunteer general practices randomized into three ar...
Article
Full-text available
BackgroundThere is concern that not all cases of chronic kidney disease (CKD) are known to general practitioners, leading to an underestimate of its true prevalence. We carried out this study to develop a model to predict the prevalence of CKD using a large English primary care dataset which includes previously undiagnosed cases of CKD.MethodsCross...
Data
Full main-effects and ‘clinical’ multivariable logistic regression models for subjects with identified Chronic Kidney Disease.
Data
Summary statistics for the total sample, and for subjects with chronic kidney disease (CKD), broken-down by identified and unidentified CKD.
Article
Full-text available
Background Anaemia is a known risk factor for cardiovascular disease and treating anaemia in chronic kidney disease (CKD) may improve outcomes. However, little is known about the scope to improve primary care management of anaemia in CKD. Methods An observational study (N = 1,099,292) with a nationally representative sample using anonymised routin...
Article
The prevalence of chronic kidney disease (CKD) and diabetes mellitus (DM) is increasing worldwide. CKD and diabetes are important risk factors for cardiovascular disease and all three conditions are key components of the multiple morbidities increasingly evident as population age in the developed world. Shared risk factors, both traditional and non...
Article
End-digit preference (EDP) is a known cause of inaccurate BP recording. Distortion has been reported around pay-for-performance (P4P) indicators. We studied sequential datasets (n = 148,000 to n = 900,000) and performed a longitudinal analysis of CONDUIT data (n = 250,000) over a 10-year period. We examined general trends in EDP and investigated th...
Data
Questionnaire: How confident are General Practitioners & the Primary care team in managing Chronic Kidney Disease (CKD).
Article
Full-text available
Much of chronic disease is managed in primary care and chronic kidney disease (CKD) is a recent addition. We are conducting a cluster randomised study of quality improvement interventions in CKD (QICKD) - Clinical Trials Registration: ISRCTN56023731. CKD registers have a lower than expected prevalence and an initial focus group study suggested vari...
Article
Full-text available
Cases of chronic kidney disease (CKD) are defined by the estimated glomerular filtration rate (eGFR), calculated using the Modified Diet in Renal Disease (MDRD) or, more recently, the CKD Epidemiology Collaboration (CKD-EPI) formula. This study set out to promote a systematic approach to reporting CKD prevalence. The study explores the impact of th...
Article
Full-text available
Health-related quality of life (QOL) is an important outcome for older people who are often on dialysis for life. Little is, however, known about differences in QOL on haemodialysis (HD) and peritoneal dialysis (PD) in older age groups. Randomising patients to either modality to assess outcomes is not feasible. In this cross-sectional, multi-centre...
Article
Full-text available
Chronic kidney disease (CKD) is a relatively recently recognised condition. People with CKD are much more likely to suffer from cardiovascular events than progress to established renal failure. Controlling systolic blood pressure should slow the progression of disease and reduce mortality and morbidity. However, no systematic review has been conduc...
Article
Full-text available
Chronic kidney disease (CKD) is associated with increased cardiovascular mortality and morbidity as well as progression to established renal failure. Interventions in primary care, particularly the lowering of blood pressure in individuals with CKD and proteinuria and diabetes, can slow disease progression. This evidence base is codified in nationa...
Article
Incorrect classification, diagnosis and coding of the type of diabetes may have implications for patient management and limit our ability to measure quality. The aim of the study was to measure the accuracy of diabetes diagnostic data and explore the scope for identifying errors. We used two sets of anonymized routinely collected computer data: the...
Article
Background: Chronic kidney disease (CKD) is an important cause of mortality and morbidity, especially in people with cardiovascular disease. Interventions that can be delivered in primary care have the potential to slow the progression of the disease. People with CKD can be identified readily and reliably from GP computer systems. Objective: To rep...
Article
Full-text available
Encapsulating peritoneal sclerosis (EPS) is a disease process that can occur as a complication of peritoneal dialysis (PD). The aim of this study was to make a general assessment of the clinical features, diagnosis, management and outcome of PD-related EPS cases from London and South-East England. Questionnaires were sent to 11 PD units in March 20...
Article
Full-text available
Chronic kidney disease (CKD) is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management of CKD, with emphasis on strict blood pressure (BP) control, reduces cardiovascular risk and slows the progression of CKD. There is currently an unprecedented rise in referral to specialist renal se...
Article
Full-text available
Chronic kidney disease, a common long-term condition, typically remains asymptomatic until the severe end stages are reached. Here, the authors describe its diagnosis and management. Copyright © 2008 Wiley Interface Ltd
Article
AA amyloidosis is the most serious potential complication of the inherited autoinflammatory syndromes and frequently results in end-stage renal failure. Although this complication is well recognized in familial Mediterranean fever, tumor necrosis factor receptor-associated periodic syndrome, and Muckle-Wells syndrome, there is only 1 previous publi...
Article
The cytoplasmic tail (CT) of megalin possesses several functional motifs likely to participate in protein-protein interactions within the proximal tubular epithelial cell (PTEC) of the kidney. One such interaction is with the phosphotyrosine interaction domain (PID) of the adaptor protein disabled-2 (Dab2), a mitogen-responsive phosphoprotein, whic...
Article
Full-text available
Diabetic nephropathy is the most common indication for long-term renal replacement therapy. In type 1 diabetes, it is rare after less than 10 or more than 35 years of disease, while the incidence in type 2 diabetes is related to the duration of diabetes. It is characterised histologically by mesangial expansion, glomerular basement membrane thicken...
Article
Pulmonary renal syndrome (PRS), defined as a combination of diffuse pulmonary hemorrhage and glomerulonephritis (GN), represents a severe syndrome for which minimal outcome data are available in the literature. We present a retrospective study of 14 consecutive patients from 1996 to 2000. Mean patient age was 65 +/- 2.1 (SEM) years, and 7 patients...

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