The first step in treating chronic kidney disease (CKD) and preventing it from worsening is proper diagnosis. However, one study finds CKD may be underdiagnosed in lower-risk groups, potentially resulting in suboptimal care. Learn what this study did, what they found, and what it means.* 

What They Did

The study gathered data from 3,330,893 US Military Health System (MHS) beneficiaries between 2016 and 2018. The beneficiaries included active-duty personnel, retirees, and their families. 

Researchers analyzed and compared patients’ data from two different sources:

• ICD-10 codes, which were used by physicians to diagnose CKD
• Laboratory data: an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2, a urinary albumin to creatinine ratio (UACR) of 30 mg/g or more, a urinary protein to creatinine ratio (UPCR) of 150 mg/g, or a dipstick urine albumin value of 1+ or greater

What They Found

Results showed that approximately 63% of CKD cases were uncoded. Without the ICD-10 code, patients are undiagnosed and not being treated for CKD. Researchers found patients with risk factors, such as diabetes and hypertension, were more likely to have the ICD-10 code for diabetes. 

Patients with uncoded CKD were more likely to be in lower-risk groups, including:

• Younger
• Female
• Active Duty
• Less Likely to be Black 
• Non-Obese
• No Chronic Illnesses (Diabetes and Hypertension)

What it Means

“Lack of CKD coding in these traditionally low CKD risk groups suggests clinicians may be missing CKD diagnosis—despite available laboratory data indicative of CKD,” the research team stated. “As a result, these individuals with uncoded CKD may not be receiving appropriate management to slow progression of the disease and address potential complications.”

*Persaud, N. (2021, June 28). CKD May Be Underdiagnosed in ‘Lower Risk’ Groups. Renal and Urology News. https://www.renalandurologynews.com/home/news/nephrology/chronic-kidney-disease-ckd/ckd-prevalence-military-families-higher-than-expected/