Creating a 13-year National Longitudinal Cohort of veterans with chronic kidney disease. BMC Nephrol 2019 Jul 03;20(1):241
Date
07/05/2019Pubmed ID
31269903Pubmed Central ID
PMC6610839DOI
10.1186/s12882-019-1430-yScopus ID
2-s2.0-85068596434 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: The development of large-scale chronic kidney disease (CKD) cohorts within the Veterans Affairs (VA) system has been limited by several factors, including the high proportion of missing race data etc. The goal of this study is to address the limitations of prior studies by creating a large cohort utilizing robust KDIGO recommendations for identifying and staging CKD.
METHODS: Multiple patient and administrative files from the Veterans Health Administration (VHA) National Patient Care were linked to create a national cohort of Veterans with chronic kidney disease (CKD) between January 2000 - December 2012; patients identified during this period were followed until 2015. CKD was defined for stages 1 through 5 if markers of kidney damage, specifically proteinuria, were present for at least 3 months. Estimated glomerular filtration rate (eGFR) values were calculated based on serum creatinine levels and the patient's age, gender, and race using both the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas.
RESULTS: About 50 million observations were collected that supported a CKD diagnosis during the study period; these observations corresponded to 3,051,001 unique veterans; 80.9% were non-Hispanic white (NHW), 13.4% were non-Hispanic black (NHB), 3.6% were Hispanic, and 2.0% were in other groups. The mean age 76.7, about 97% were male and 50.2% died prior to January 2016. Among those with stage 3, 12.3% progressed to stage 4, 21.6% of those with stage 4 progressed to stage 5. We found that eGFR values calculated from serum creatinine levels identified about 98% of all patients, while about 11.4% of patients could be identified through ICD-9 codes; only 6.4% could be identified through both sources.
CONCLUSION: This 13-year national cohort provides an important resource for answering numerous research questions in the future such as racial/ethnic disparities questions, tracking health service utilization, medication adherence, cost and health outcomes in veterans with CKD.
Author List
Ozieh MN, Gebregziabher M, Ward RC, Taber DJ, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMukoso Nwamaka Ozieh MD Assistant Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Cohort Studies
Female
Glomerular Filtration Rate
Humans
Longitudinal Studies
Male
Renal Insufficiency, Chronic
Time Factors
United States
United States Department of Veterans Affairs
Veterans
