Article Figures & Data
Figures
- Figure 1. Flowchart of patient inclusions and exclusions
- Figure 2. Among people with type 2 diabetes and no previous evidence of CKD stage G3–5, (A) The incidence rates of CKD diagnosis via a diagnosis code (code), eGFR-based criteria (lab) or at least one of these (either), and their 95% confidence intervals. (B) Rates of eGFR measurement, by fiscal year. CKD = chronic kidney disease. eGFR = estimated glomerular filtration rate.
Tables
Variable Patients with T2D and no previous evidence of CKD stages G3–5 (n = 32 276) Median age, years (IQR) 60 (50–70) Sex, n (%) Female 13 865 (43.0) Male 18 411 (57.0) Median duration of follow-up, years (IQR) 5.01 (2.31–6.00) Median duration of diabetes, years (IQR) 1.8 (0.0–7.0) CKD diagnosis code, n (%) 1463 (4.5) Median time to diagnosis code, years (IQR) 3.10 (1.49–5.41) eGFR-based CKD, n (%) 2667 (8.3) Median time to lab-based CKD, years (IQR) 2.66 (1.26–4.41) Lab-based or coded CKD, n (%) 3102 (9.6) Median time to lab-based or coded CKD, years (IQR) 2.52 (1.12–4.36) Deprivation decile, n (%) 1–2 (highly deprived) 13 945 (43.2) 3–4 6070 (18.8) 5–6 3309 (10.3) 7–10 (least deprived) 8952 (27.7) General practices, n 60 Median number of patients per practice (IQR) 472 (277–603) CKD = chronic kidney disease. eGFR = estimated glomerular filtration rate. IQR = interquartile range. T2D = type 2 diabetes.
- Table 2. Odds ratios (OR) and 95% confidence intervals from a logistic regression model to identify factors associated with diagnostic coding of eGFR-based cases
Variable Group OR (95% CI) P value Age 0.973 (0.963 to 0.982) 0.00 Sex Female (ref) Male 1.069 (0.913, to1.252) 0.41 Duration of diabetes, years 0.999 (0.991 to 1.008) 0.89 Deprivation decile 1–2 (ref) 3–4 1.090 (0.945 to 1.257) 0.24 5–6 1.028 (0.865 to 1.222) 0.75 7–10 0.942 (0.773 to 1.148) 0.55 eGFR stage G3A (ref) G3B 1.206 (0.932 to 1.559) 0.15 G4 1.796 (1.074 to 3.046) 0.03 G5 1.023 (0.365 to 2.859) 0.97 Time between qualifying eGFRs, months 0.853 (0.647 to 1.124) 0.26 Urine albumin-to-creatinine ratio Not measured (ref) A1 1.298 (1.081 to 1.559) 0.01 A2 1.078 (0.855 to 1.360) 0.52 A3 1.310 (0.904 to 1.904) 0.15 HbA1c control Controlled (ref) Uncontrolled 1.105 (0.920 to 1.329) 0.29 Unmeasured 1.502 (1.163 to 1.941) 0.00 History of cardiovascular disease 1.080 (0.878 to 1.329) 0.46 Prescribed antihypertensives 0.980 (0.795 to 1.210) 0.85 Prescribed statins 0.995 (0.845 to 1.172) 0.95 Prescribed insulin 1.194 (0.965 to 1.478) 0.10 Prescribed SGLT2 inhibitors 0.904 (0.563, to 1.447) 0.67 eGFR = estimated glomerular filtration rate. SGLT2 = sodium-glucose co-transporter-2.
- Table 3. Number of patients with eGFR-based chronic kidney disease (CKD) and a CKD diagnosis code, the proportion that occurred on or after their second qualifying eGFR measurement and the time between the second qualifying eGFR measurement and entry of a diagnostic code
Variable Group Patients, n Diagnosis code after eGFR-based CKD, n (%) Median time from eGFR-based CKD to CKD diagnosis code, months (IQR) Age group, years <40 3 1 (33.3) 0.7 (0.7–0.7) 40–49 19 11 (57.9) 2.9 (1.9–9.6) 50–59 111 56 (50.5) 8.9 (1.1–16.3) 60–69 298 156 (52.3) 10.9 (2.0–28.2) 70–79 496 293 (59.1) 9.9 (1.0–24.8) ≥80 283 151 (53.4) 8.9 (0.9–20.6) Sex Female 566 319 (56.4) 10.6 (1.1–24.1) Male 644 349 (54.2) 9.0 (1.2–24.3) Duration of T2DM <1 year 77 48 (62.3) 11.8 (0.8–26.2) 1–2 years 69 44 (63.8) 10.1 (2.0–27.2) 2–5 years 177 94 (53.1) 7.6 (0.7–26.1) 5–10 years 359 179 (49.9) 9.7 (1.1–21.4) >10 years 528 303 (57.4) 10.2 (1.5–23.2) CKD stage G3A 1025 569 (55.5) 9.9 (1.2–25.3) G3B 139 78 (56.1) 10.2 (1.2–20.4) G4 38 17 (44.7) 7.3 (0.7–16.6) G5 8 4 (50.0) 7.2 (2.8–21.5) Total Overall 1210 668 (55.2) 9.8 (1.2–24.3) eGFR = estimated glomerular filtration rate. CKD = chronic kidney disease. IQR = interuartile range. T2DM = type 2 diabetes mellitus.
Supplementary Data
- RS_10.3399BJGPO.2023.0079_supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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Diagnosis codes underestimate chronic kidney disease incidence compared with eGFR-based evidence: a retrospective observational study of patients with type 2 diabetes in UK primary care
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