scholarly journals Do routine hospital data accurately record comorbidity in advanced kidney disease populations? A record linkage cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ailish Nimmo ◽  
Retha Steenkamp ◽  
Rommel Ravanan ◽  
Dominic Taylor
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
International Classification Of Diseases ◽  
Medical Conditions ◽  
Hospital Data ◽  
Full Spectrum ◽  
Predictive Values ◽  
Advanced Chronic Kidney Disease ◽  
Sensitivity Specificity

Abstract Background Routine healthcare datasets capturing clinical and administrative information are increasingly being used to examine health outcomes. The accuracy of such data is not clearly defined. We examine the accuracy of diagnosis recording in individuals with advanced chronic kidney disease using a routine healthcare dataset in England with comparison to information collected by trained research nurses. Methods We linked records from the Access to Transplant and Transplant Outcome Measures study to the Hospital Episode Statistics dataset. International Classification of Diseases (ICD-10) and Office for Population Censuses and Surveys Classification of Interventions and Procedures (OPCS-4) codes were used to identify medical conditions from hospital data. The sensitivity, specificity, positive and negative predictive values were calculated for a range of diagnoses. Results Comorbidity information was available in 96% of individuals prior to starting kidney replacement therapy. There was variation in the accuracy of individual medical conditions identified from the routine healthcare dataset. Sensitivity and positive predictive values ranged from 97.7 and 90.4% for diabetes and 82.6 and 82.9% for ischaemic heart disease to 44.2 and 28.4% for liver disease. Conclusions Routine healthcare datasets accurately capture certain conditions in an advanced chronic kidney disease population. They have potential for use within clinical and epidemiological research studies but are unlikely to be sufficient as a single resource for identifying a full spectrum of comorbidities.

Association of age with risk of major depression among patients with chronic kidney disease over midlife: a nationwide cohort study in Taiwan

2018 ◽  
Vol 31 (08) ◽  
pp. 1171-1179 ◽  
Author(s):  
Shih-Feng Chen ◽  
Yu-Huei Chien ◽  
Pau-Chung Chen ◽  
I-Jen Wang
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Major Depression ◽  
Kidney Disease ◽  
Comparison Group ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Classification Of Diseases ◽  
The Impact

ABSTRACTBackground:The impact of age on the development of depression among patients with chronic kidney disease (CKD) at stages before dialysis is not well known. We aimed to explore the incidence of major depression among predialysis CKD patients of successively older ages through midlife.Methods:We conducted a retrospective cohort study using the longitudinal health insurance database 2005 in Taiwan. This study investigated 17,889 predialysis CKD patients who were further categorized into study (i.e. middle and old-aged) groups and comparison group aged 18–44. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was applied for coding diseases.Results:The group aged 75 and over had the lowest (hazard ratio [HR] 0.47; 95% confidence interval [CI] 0.32–0.69) risk of developing major depression, followed by the group aged 65–74 (HR 0.67; 95% CI 0.49–0.92), using the comparison group as reference. The adjusted survival curves showed significant differences in cumulative major depression-free survival between different age groups. We observed that the risk of major depression development decreases with higher age. Females were at a higher risk of major depression than males among predialyasis CKD patients.Conclusions:The incidence of major depression declines with higher age in predialysis CKD patients over midlife. Among all age groups, patients aged 75 and over have the lowest risk of developing major depression. A female preponderance in major depression development is present. We suggest that depression prevention and therapy should be integrated into the standard care for predialysis CKD patients, especially for those young and female.

scholarly journals Gout and the risk of advanced chronic kidney disease in the UK health system: a national cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031550 ◽  
Author(s):  
Austin G Stack ◽  
Michelle Elizabeth Johnson ◽  
Betina Blak ◽  
Alyssa Klein ◽  
Lewis Carpenter ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
International Classification Of Diseases ◽  
Secondary Outcome ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Advanced Chronic Kidney Disease ◽  
National Cohort

ObjectiveEvaluate the association between gout and risk of advanced chronic kidney disease (CKD).DesignRetrospective matched cohort study.SettingUK Clinical Practice Research Datalink.ParticipantsThe analysis included data for 68 897 patients with gout and 554 964 matched patients without gout. Patients were aged ≥18 years, registered at UK practices, had ≥12 months of clinical data and had data linked with Hospital Episode Statistics. Patients were excluded for history of advanced CKD, juvenile gout, cancer, HIV, tumour lysis syndrome, Lesch-Nyhan syndrome or familial Mediterranean fever.Primary and secondary outcome measuresAdvanced CKD was defined as first occurrence of: (1) dialysis, kidney transplant, diagnosis of end-stage kidney disease (ESKD) or stage 5 CKD (diagnostic codes in Read system or International Classification of Diseases, Tenth Revision); (2) estimated glomerular filtration rate (eGFR) <10 mL/min/1.73 m²; (3) doubling of serum creatinine from baseline and (4) death associated with CKD.ResultsAdvanced CKD incidence was higher for patients with gout (8.54 per 1000 patient-years; 95% CI 8.26 to 8.83) versus without gout (4.08; 95% CI 4.00 to 4.16). Gout was associated with higher advanced CKD risk in both unadjusted analysis (HR, 2.00; 95% CI 1.92 to 2.07) and after adjustment (HR, 1.29; 95% CI 1.23 to 1.35). Association was strongest for ESKD (HR, 2.13; 95% CI 1.73 to 2.61) and was present for eGFR <10 mL/min/1.73 m² (HR, 1.45; 95% CI 1.30 to 1.61) and serum creatinine doubling (HR, 1.13; 95% CI 1.08 to 1.19) but not CKD-associated death (HR, 1.14; 95% CI 0.99 to 1.31). Association of gout with advanced CKD was replicated in propensity-score matched analysis (HR, 1.23; 95% CI 1.17 to 1.29) and analysis limited to patients with incident gout (HR, 1.28; 95% CI 1.22 to 1.35).ConclusionsGout is associated with elevated risk of CKD progression. Future studies should investigate whether controlling gout is protective and reduces CKD risk.

Classification of non-chronic and chronic kidney disease using SVM neural networks

2017 ◽  
Vol 7 (1.3) ◽  
pp. 191 ◽  
Author(s):  
Ravindra B.V ◽  
N Sriraam ◽  
M Geetha
Keyword(s):  
Neural Networks ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Classification Accuracy ◽  
The Body ◽  
Support Vector ◽  
Potential Candidate ◽  
Kidney Dialysis ◽  
Sensitivity Specificity

Chronic kidney disease (CKD) refers to the failure of the renal functionalities that leads to the deposition of wastes, electrolytes and other fluids in the body. It is very important to recognize the symptoms that cause the CKD and pathological blood and urine test indicates the key attributes. It is well fact that one has to undergo dialysis due to renal failure. The severity level of disease can be predicted as well as classified using appropriate computer aided quantitative tools. This specific study discusses the classification of chronic and non-chronic kidney disease NCKD using support vector machine (SVM) neural networks. The simulation study makes use of UCI repository CKD datasets with n=400. In order to train to train the attributes of kidney dialysis four cases were considered by including the nominal and numerical values. A radical basis kernel function was employed to train SVM. The performance of the proposed scheme is evaluated in terms of the sensitivity, specificity and classification accuracy. Results reveal an overall classification accuracy of 94.44% was obtained by combining 6 attributes. It can be concluded that the SVM based approach found to be a potential candidate for classification of CKD and NCKD.

scholarly journals Prevalence of Chronic Kidney Disease, Thrombotic Cardiovascular Events, and Use of Oral P2Y12 Inhibitors among Veterans

2018 ◽  
Vol 47 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Manisha Singh ◽  
Deepa Raghavan ◽  
James S. Williams ◽  
Bradley C. Martin ◽  
Teresa J. Hudson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Patient Population ◽  
International Classification Of Diseases ◽  
Period Prevalence ◽  
P2y12 Inhibitors ◽  
Classification Of Diseases ◽  
Pharmacy Data ◽  
Cost Differences

Background: Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescription trend for P2Y12i remains unclear. Methods: Using national VA corporate warehouse data, we used International Classification of Diseases-9 codes to identify Veterans with CKD, dialysis-dependent CKD, and CV events. VA pharmacy data were used to count P2Y12i prescriptions for the federal fiscal years (FY) 2011 through 2015. Results: The period prevalence of Veterans with CKD was 378,233 (6.1%). The point prevalence of CKD increased by 49% from 132,979 (2.30%) in FY11 to 213,444 (3.42%) in FY15. The period prevalence of Veterans with dialysis-dependent CKD was 150,298 (2.4%). In all, 128,703 (56.7%) CV events occurred in Veterans with CKD. Veterans with CKD were given 50.1% of prescriptions for clopidogrel, 49.3% for prasugrel, and 60.4% for ticagrelor. In this patient population, year-to-year increases in P2Y12i prescriptions were observed with a dramatic increase in ticagrelor prescriptions. Conclusion: CKD is common among Veterans and its true prevalence is likely being underestimated. The prevalence of dialysis-dependent CKD is higher among Veterans than the non-Veteran US population. CV events are widely co-prevalent and these patients are commonly prescribed P2Y12i. The recent increase in ticagrelor prescriptions in this patient population and large cost differences between the 3 P2Y12i underline the need for future studies to identify the preferred P2Y12i for these patients.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

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