Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011
Schroeder EB, Powers JD, O'Connor PJ, Nichols GA, Xu S, Desai JR, Karter AJ, Morales LS, Newton KM, Pathak RD, Vazquez-Benitez G, Raebel MA, Butler MG, Elston Lafata J, Reynolds K, Thomas A, Waitzfelder BE, Steiner JF. Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011. Journal of Diabetes and Its Complications 2015; 29(5):637-643.
Journal of Diabetes and Its Complications
AIMS: Diabetes is a leading cause of chronic kidney disease (CKD). Different methods of CKD ascertainment may impact prevalence estimates. We used data from 11 integrated health systems in the United States to estimate CKD prevalence in adults with diabetes (2005-2011), and compare the effect of different ascertainment methods on prevalence estimates.
METHODS: We used the SUPREME-DM DataLink (n = 879,312) to estimate annual CKD prevalence. Methods of CKD ascertainment included: diagnosis codes alone, impaired estimated glomerular filtration rate (eGFR) alone (eGFR < 60 mL/min/1.73 m(2)), albuminuria alone (spot urine albumin creatinine ratio > 30 mg/g or equivalent), and combinations of these approaches.
RESULTS: CKD prevalence was 20.0% using diagnosis codes, 17.7% using impaired eGFR, 11.9% using albuminuria, and 32.7% when one or more method suggested CKD. The criteria had poor concordance. After age- and sex-standardization to the 2010 U.S. Census population, prevalence using diagnosis codes increased from 10.7% in 2005 to 14.3% in 2011 (P < 0.001). The prevalence using eGFR decreased from 9.7% in 2005 to 8.6% in 2011 (P < 0.001).
CONCLUSIONS: Our data indicate that CKD prevalence and prevalence trends differ according to the CKD ascertainment method, highlighting the necessity for multiple sources of data to accurately estimate and track CKD prevalence.
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Albuminuria; Cohort Studies; Delivery of Health Care, Integrated; Diabetic Nephropathies; Electronic Health Records; Epidemiological Monitoring; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Information Storage and Retrieval; International Classification of Diseases; Male; Middle Aged; Prevalence; Registries; Renal Insufficiency, Chronic; United States; Young Adult