Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
OBJECTIVE
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.
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado. Electronic address: Emily.X.Schroeder@kp.org.
Emily B
EB
Schroeder
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
J David
JD
Powers
HealthPartners Institute for Education and Research, Minneapolis, Minnesota.
Patrick J
PJ
O'Connor
Kaiser Permanente Center for Health Research, Portland, Oregon.
Gregory A
GA
Nichols
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
Stanley
S
Xu
HealthPartners Institute for Education and Research, Minneapolis, Minnesota.
Jay R
JR
Desai
Division of Research, Kaiser Permanente Northern California, Oakland, California.
Andrew J
AJ
Karter
Group Health Research Institute, Seattle, Washington.
Leo S
LS
Morales
Group Health Research Institute, Seattle, Washington.
Katherine M
KM
Newton
Marshfield Clinic, Marshfield, Wisconsin.
Ram D
RD
Pathak
HealthPartners Institute for Education and Research, Minneapolis, Minnesota.
Gabriela
G
Vazquez-Benitez
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
Marsha A
MA
Raebel
Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, Georgia.
Melissa G
MG
Butler
Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, Virginia; Henry Ford Health System, Detroit, Michigan.
Jennifer Elston
JE
Lafata
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
Kristi
K
Reynolds
Henry Ford Health System, Detroit, Michigan.
Abraham
A
Thomas
Kaiser Permanente Center for Health Research, Honolulu, Hawaii.
Beth E
BE
Waitzfelder
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado.
John F
JF
Steiner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology; D015331:Cohort Studies; D019033:Delivery of Health Care, Integrated; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D057286:Electronic Health Records; D062665:Epidemiological Monitoring; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D016247:Information Storage and Retrieval; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Chronic renal insufficiency; Diabetes mellitus; Electronic health records; Epidemiology; Prevalence