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Renal Disease

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH890
Version ID
1859
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2018-10-15
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Self-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.

Methods:

The UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.

Findings:

Overall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.

Interpretation:

Within primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018.

Clinical Code List

Rows: 60
Code Description Entity type Coding System (ICD-10 Read) Category
14D1.00 H/O: nephritis res69: renal_disease Read diagnostic
1Z10.00 Chronic kidney disease stage 1 res69: renal_disease Read diagnostic
1Z11.00 Chronic kidney disease stage 2 res69: renal_disease Read diagnostic
1Z12.00 Chronic kidney disease stage 3 res69: renal_disease Read diagnostic
1Z13.00 Chronic kidney disease stage 4 res69: renal_disease Read diagnostic
1Z14.00 Chronic kidney disease stage 5 res69: renal_disease Read diagnostic
K0...00 Nephritis, nephrosis and nephrotic syndrome res69: renal_disease Read diagnostic
K001.00 Acute nephritis with lesions of necrotising glomerulitis res69: renal_disease Read diagnostic
K012.00 Nephrotic syndrome+membranoproliferative glomerulonephritis res69: renal_disease Read diagnostic
K019.00 Nephrotic syn,diffuse mesangiocapillary glomerulonephritis res69: renal_disease Read diagnostic
K02..00 Chronic glomerulonephritis res69: renal_disease Read diagnostic
K02..11 Nephritis - chronic res69: renal_disease Read diagnostic
K02..12 Nephropathy - chronic res69: renal_disease Read diagnostic
K021.00 Chronic membranous glomerulonephritis res69: renal_disease Read diagnostic
K022.00 Chronic membranoproliferative glomerulonephritis res69: renal_disease Read diagnostic
K023.00 Chronic rapidly progressive glomerulonephritis res69: renal_disease Read diagnostic
K02y000 Chronic glomerulonephritis + diseases EC res69: renal_disease Read diagnostic
K02y200 Chronic focal glomerulonephritis res69: renal_disease Read diagnostic
K02y300 Chronic diffuse glomerulonephritis res69: renal_disease Read diagnostic
K02yz00 Other chronic glomerulonephritis NOS res69: renal_disease Read diagnostic
K02z.00 Chronic glomerulonephritis NOS res69: renal_disease Read diagnostic
K03..00 Nephritis and nephropathy unspecified res69: renal_disease Read diagnostic
K03..11 Nephritis and nephropathy unspecified res69: renal_disease Read diagnostic
K032.00 Membranoproliferative nephritis unspecified res69: renal_disease Read diagnostic
K032000 Focal membranoproliferative glomerulonephritis res69: renal_disease Read diagnostic
K032y00 Nephritis unsp+OS membranoprolif glomerulonephritis lesion res69: renal_disease Read diagnostic
K032y13 Mesangioproliferative glomerulonephritis NEC res69: renal_disease Read diagnostic
K032y14 Mesangiocapillary glomerulonephritis NEC res69: renal_disease Read diagnostic
K032z00 Nephritis unsp+membranoprolif glomerulonephritis lesion NOS res69: renal_disease Read diagnostic
K034.00 Renal cortical necrosis unspecified res69: renal_disease Read diagnostic
K035.00 Renal medullary necrosis unspecified res69: renal_disease Read diagnostic
K041.00 Acute renal cortical necrosis res69: renal_disease Read diagnostic
K042.00 Acute renal medullary necrosis res69: renal_disease Read diagnostic
K04y.00 Other acute renal failure res69: renal_disease Read diagnostic
K04z.00 Acute renal failure NOS res69: renal_disease Read diagnostic
K05..00 Chronic renal failure res69: renal_disease Read diagnostic
K050.00 End stage renal failure res69: renal_disease Read diagnostic
K06..00 Renal failure unspecified res69: renal_disease Read diagnostic
K060.11 Impaired renal function res69: renal_disease Read diagnostic
K080.00 Renal osteodystrophy res69: renal_disease Read diagnostic
K080000 Phosphate-losing tubular disorders res69: renal_disease Read diagnostic
K080100 Renal dwarfism res69: renal_disease Read diagnostic
K080200 Renal infantilism res69: renal_disease Read diagnostic
K080300 Renal rickets res69: renal_disease Read diagnostic
K080z00 Renal osteodystrophy NOS res69: renal_disease Read diagnostic
K081.00 Nephrogenic diabetes insipidus res69: renal_disease Read diagnostic
K08y000 Hypokalaemic nephropathy res69: renal_disease Read diagnostic
K08yz00 Other impaired renal function disorder NOS res69: renal_disease Read diagnostic
K08z.00 Impaired renal function disorder NOS res69: renal_disease Read diagnostic
K0A3200 Chron nephritic syndrom difuse membranous glomerulonephritis res69: renal_disease Read diagnostic
K0A3300 Chron neph syn difus mesangial prolifrtiv glomerulonephritis res69: renal_disease Read diagnostic
K0A3500 Chronic neph syn difus mesangiocapillary glomerulonephritis res69: renal_disease Read diagnostic
K0A3700 Chronic nephritic syn diffuse crescentic glomerulonephritis res69: renal_disease Read diagnostic
K0A5500 [X]Heredtry nephrpthy NEC difus mesangiocapilry glomneph res69: renal_disease Read diagnostic
K100000 Chronic pyelonephritis without medullary necrosis res69: renal_disease Read diagnostic
K100100 Chronic pyelonephritis with medullary necrosis res69: renal_disease Read diagnostic
K101000 Acute pyelonephritis without medullary necrosis res69: renal_disease Read diagnostic
Kyu2.00 [X]Renal failure res69: renal_disease Read diagnostic
Kyu2000 [X]Other acute renal failure res69: renal_disease Read diagnostic
Kyu2100 [X]Other chronic renal failure res69: renal_disease Read diagnostic
Rows: 13
Code Description Entity type Coding System (ICD-10 Read) Category
I12 Hypertensive renal disease res69: renal_disease ICD-10 diagnostic
I13 Hypertensive heart and renal disease res69: renal_disease ICD-10 diagnostic
N00 Acute nephritic syndrome res69: renal_disease ICD-10 diagnostic
N01 Rapidly progressive nephritic syndrome res69: renal_disease ICD-10 diagnostic
N02 Recurrent and persistent haematuria res69: renal_disease ICD-10 diagnostic
N03 Chronic nephritic syndrome res69: renal_disease ICD-10 diagnostic
N04 Nephrotic syndrome res69: renal_disease ICD-10 diagnostic
N05 Unspecified nephritic syndrome res69: renal_disease ICD-10 diagnostic
N07 Herediatry nephropathy, not elsewhere classified res69: renal_disease ICD-10 diagnostic
N11 Chronic tubulo-interstitial nephritis res69: renal_disease ICD-10 diagnostic
N14 Drug- and heavy-metal-induced tubulo-interstitial and tubular conditions res69: renal_disease ICD-10 diagnostic
N17-N19 Renal failure res69: renal_disease ICD-10 diagnostic
Q61 Cystic kidney disease res69: renal_disease ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH890/version/1859/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH890/version/1859/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH890', '1859', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH890/version/1859/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH890/version/1859/export/codes/?format=json
CSV site_root/phenotypes/PH890/version/1859/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH890', '1859', api_client=client)

Version History

Version
ID
Name Owner Publish date
1859 Renal Disease ieuan.scanlon 2022-04-04 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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