Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005–2011

• Published in: Journal of diabetes and its complications 2015-07, Vol.29 (5), p.637-643
• Main Authors: Schroeder, Emily B, Powers, J. David, O’Connor, Patrick J, Nichols, Gregory A, Xu, Stanley, Desai, Jay R, Karter, Andrew J, Morales, Leo S, Newton, Katherine M, Pathak, Ram D, Vazquez-Benitez, Gabriela, Raebel, Marsha A, Butler, Melissa G, Lafata, Jennifer Elston, Reynolds, Kristi, Thomas, Abraham, Waitzfelder, Beth E, Steiner, John F
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aged, 80 and over; Albuminuria - etiology; Cardiovascular disease; Chronic renal insufficiency; Codes; Cohort Studies; Delivery of Health Care, Integrated; Diabetes; Diabetes mellitus; Diabetic Nephropathies - epidemiology; Diabetic Nephropathies - physiopathology; Diabetic Nephropathies - urine; Disease control; Disease prevention; Electronic Health Records; Endocrinology & Metabolism; Epidemiological Monitoring; Epidemiology; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Information Storage and Retrieval; International Classification of Diseases; Kidney diseases; Laboratories; Male; Medicare; Methods; Middle Aged; Mortality; Population; Prevalence; Registries; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - urine; Surveillance; United States - epidemiology; Young Adult
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2015.04.007

Abstract 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 m2 ), 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.