Kevin Harris's research while affiliated with University of Leicester and other places

Publications (12)

Article
Full-text available
Background: Uncertainty exists regarding the optimal method to estimate glomerular filtration rate (GFR) for disease detection and monitoring. Widely used GFR estimates have not been validated in British ethnic minority populations. Methods/design: Iohexol measured GFR will be the reference against which each estimating equation will be compared...
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
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
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
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...
Data
Questionnaire: How confident are General Practitioners & the Primary care team in managing Chronic Kidney Disease (CKD).
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
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
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
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...

Citations

... While the researchers used a large sample for the development of the models, they did not consider medication use for inclusion in the models. Other studies have used large data sets comprised of routinely collected data, such as electronic health records or insurance claims (14)(15)(16)(17)(18)(19). However, routinely collected data may suffer from misclassification bias and underreporting as a result of the data not being collected for the purpose of research (20). ...
... This study has similarities to an ongoing study: the eGFR-C study 16 which also aims to assess the value of creatinine-and cystatin C-derived eGFR for predicting future renal decline. It is intended that eGFR-C will have a higher proportion of non-white participants, as well as participants with baseline proteinuria, who were poorly represented in FORM-2C, and will be followed up over three years. ...
... It is therefore understandable that women who need insulin during pregnancy may in fact have higher insulin resistance and a higher probability of having a previously undiagnosed AGH or T2DM and not only GDM. In our study, 31.6% of the women missed the reclassification visit, being in line with the literature, with 20.0-50.2% of women with GDM being reported to be lost to follow-up [13,16,[36][37][38][39]. The non-adherence to follow-up after delivery may be due to various reasons. ...
... The prevalence of Chronic Kidney Disease (CKD) stages 3-5 in the UK is reported to be between 5.8% [1] and 8.5% [2], with the prevalence increasing with age [1][2][3]. Estimates of over 40% have commonly been described in Europe and the United States, in community dwelling older people aged over 80 years [4,5]. ...
... It has been successfully applied in a number of contexts, including the QICKD trial to improve blood pressure management in CKD. 11 It takes advantage of the high quality of CMRs in UK primary care, which enables people with CKD to be identified and data about quality to be readily extracted. ABE meets the Medical Research Council's definition of a complex intervention. ...
... The prevalence of anemia in CKD increases with declining kidney function, affecting 8.6% of people with stage 3-5 CKD. 3 People living with diabetes develop anemia earlier in the course of kidney disease and are more likely to be anemic than those without diabetes. 4 Anemia management in CKD has been extensively studied in specialist care settings and in those receiving dialysis. ...
... Previous studies have demonstrated potential gaps in guideline-recommended treatment and monitoring of CKD [18][19][20]. In addition, low diagnosis rates of early stage CKD have been reported in Italy [21], Sweden [20], the UK [22] and the USA [19,[23][24][25][26], and in patients with specific CKD aetiologies (e.g. diabetic kidney disease) [25,27]. ...
... 8 Barriers that hinder effective CKD care in primary care settings include lack of awareness and understanding of guidelines for risk stratification and management of CKD, confusion regarding appropriate referral criteria and timing, and lack of confidence in managing CKD. 9 Additionally, PCPs have limited time to manage complex visit agendas. 10,11 The advent of electronic health records (EHRs) has propelled an interest in using electronic decision supports to improve care. ...
... Although the creatinine-based estimated glomerular filtration rate (eGFR) is useful for evaluating the renal function in clinical practice (5), the difference between the actual GFR measured using inulin and the eGFR increases along with the actual GFR value (6)(7)(8)(9). Therefore, assessing the renal function using eGFR at a single time point is often inadequate for the identification of CKD (10). The rate of eGFR decline has recently received much attention as an outcome in clinical research and may be useful for predicting progression to ESRD (11)(12)(13). ...
... Quality improvement strategies are used in different clinical areas, including hypertension and chronic kidney disease (CKD) [5,6]. A good proportion of papers dealing with quality improvement in end-stage kidney disease (ESKD) is from the USA [4,7,8]. ...