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

Schroeder EB1, Powers JD2, O'Connor PJ3, Nichols GA4, Xu S2, Desai JR3, Karter AJ5, Morales LS6, Newton KM6, Pathak RD7, Vazquez-Benitez G3, Raebel MA8, Butler MG9, Lafata JE10, Reynolds K11, Thomas A12, Waitzfelder BE13, Steiner JF14; SUPREME-DM Study Group.

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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 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, prevalenceusing 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.