Creating a 13-year National Longitudinal Cohort of veterans with chronic kidney disease

BMC Nephrology

  ^{1    2    3    4    5} 

[1] 0000 0001 2111 8460, grid.30760.32, Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA;0000 0001 2111 8460, grid.30760.32, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, 53226-3596, Milwaukee, WI, USA;0000 0001 2111 8460, grid.30760.32, Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA;0000 0001 2111 8460, grid.30760.32, Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, USA;0000 0004 0420 7009, grid.413906.9, Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA;Ralph H. Johnson Department of Veterans Affairs Medical Center, Health Equity and Rural Outreach Innovation Center, Charleston, SC, USA;Ralph H. Johnson Department of Veterans Affairs Medical Center, Health Equity and Rural Outreach Innovation Center, Charleston, SC, USA;0000 0001 2189 3475, grid.259828.c, Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA;Ralph H. Johnson Department of Veterans Affairs Medical Center, Health Equity and Rural Outreach Innovation Center, Charleston, SC, USA;0000 0001 2189 3475, grid.259828.c, Department of Surgery, Medical University of South Carolina (MUSC), Charleston, SC, USA;

关键词: Veterans;    CKD;    Kidney disease;   

DOI  :  10.1186/s12882-019-1430-y

来源: publisher

【 摘 要 】

BackgroundThe 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.MethodsMultiple 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.ResultsAbout 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.ConclusionThis 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.

【 授权许可】

CC BY