Development and validation of an electronic health record-based chronic kidney disease registry.
OBJECTIVE
Chronic kidney disease (CKD) is increasing, and outcomes-related research from diverse health care settings is needed to target appropriate efforts and interventions. We developed an electronic health record (EHR)-based CKD registry at the Cleveland Clinic and validated comorbid conditions.


METHODS
Patients who had at least one face-to-face outpatient encounter with a Cleveland Clinic health care provider and (1) had two estimated GFR values <60 ml/min per 1.73 m(2) >90 days apart as of January 1, 2005 and/or (2) were patients with International Classification of Diseases-9 (ICD-9) diagnosis codes for kidney disease were included.


RESULTS
Our registry includes 57,276 patients (53,399 patients met estimated GFR criteria and 3877 patients met ICD-9 diagnosis code criteria) as of March 2010. Mean age was 69.5 ± 13.4 years, with 55% women and 12% African Americans. Medicare is the primary insurer for more than one half of the study cohort. The κ statistics to assess the extent of agreement between the administrative dataset extracted from the EHR and actual EHR chart review showed substantial agreement (>0.80) for all conditions except for coronary artery disease and hypertension, which had moderate agreement (<0.60).


CONCLUSIONS
Development of an EHR-based CKD registry is feasible in a large health system, and the comorbid conditions included in the registry are reliable. In addition to conducting research studies, such a registry could help to improve the quality of care delivered to CKD patients and complement the ongoing nationwide efforts to develop a CKD surveillance project.
Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, 9500 Euclid Avenue, Q7, Cleveland Clinic, Cleveland, OH 44195, USA. navanes@ccf.org
Sankar D
SD
Navaneethan
Stacey E
SE
Jolly
Jesse D
JD
Schold
Susana
S
Arrigain
Welf
W
Saupe
John
J
Sharp
Jennifer
J
Lyons
James F
JF
Simon
Martin J
MJ
Schreiber
Anil
A
Jain
Joseph V
JV
Nally
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D057286:Electronic Health Records; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012042:Registries