PMID- 36158147
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220928
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 15
IP  - 10
DP  - 2022 Oct
TI  - The hidden diabetic kidney disease in a university hospital-based population: a 
      real-world data analysis.
PG  - 1865-1871
LID - 10.1093/ckj/sfac100 [doi]
AB  - BACKGROUND: Correct identification of diabetic kidney disease (DKD) in type 2 
      diabetes mellitus (T2DM) patients is crucial to implement therapeutic 
      interventions that may prevent disease progression. METHODS: We compared the real 
      prevalence of DKD in T2DM patients according to actual serum and urine laboratory 
      data with the presence of the diagnostic terms DKD and/or CKD on the electronic 
      medical records (EMRs) using a natural language processing tool (SAVANA Manager). 
      All patients >18 years of age and diagnosed with T2DM were selected. DKD was 
      defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) or 
      a urinary albumin:creatinine ratio (UACR) >30 mg/g or a urinary 
      protein:creatinine ratio (UPCR) >0.3 g/g after excluding acute kidney injury. 
      RESULTS: A total of 15 304 T2DM patients identified on EMRs were eligible to 
      enter the study. A total of 4526 (29.6%) T2DM patients had DKD according to lab 
      criteria. However, the terms CKD or DKD were only present in 33.1% and 7.5%, 
      representing a hidden prevalence of CKD and DKD of 66.9% and 92.5%, respectively. 
      Less severe kidney disease (lower UACR or UPCR, higher eGFR values), female sex 
      and lack of insulin prescription were associated with the absence of DKD or CKD 
      terms in the EMRs (P < .001). CONCLUSIONS: The prevalence of DKD among T2DM 
      patients defined by lab data is significantly higher than that reported on 
      hospital EMRs. This could imply underdiagnosis of DKD, especially in patients 
      with the least severe disease who may benefit the most from optimized therapy.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.
FAU - Marques, Maria
AU  - Marques M
AUID- ORCID: 0000-0001-9691-2546
AD  - Nephrology Department, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, 
      Spain.
AD  - Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
FAU - Lopez-Sanchez, Paula
AU  - Lopez-Sanchez P
AUID- ORCID: 0000-0002-4332-5759
AD  - Nephrology Department, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, 
      Spain.
FAU - Tornero, Fernando
AU  - Tornero F
AD  - Nephrology Department, Hospital Universitario del Sureste, Madrid, Spain.
FAU - Gargantilla, Pedro
AU  - Gargantilla P
AD  - Internal Medicine Department, Hospital El Escorial, Madrid, Spain.
FAU - Maroto, Alba
AU  - Maroto A
AD  - Nephrology Department, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, 
      Spain.
FAU - Ortiz, Alberto
AU  - Ortiz A
AUID- ORCID: 0000-0002-9805-9523
AD  - Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
AD  - Nephrology Department, Fundacion Jimenez Diaz, Madrid, Spain.
FAU - Portoles, Jose
AU  - Portoles J
AUID- ORCID: 0000-0002-2114-1385
AD  - Nephrology Department, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, 
      Spain.
AD  - Research Network REDInREN 016/009/009 Instituto Salud Carlos III, Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20220414
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
CIN - doi: 10.1093/ckj/sfac163
PMC - PMC9494513
OTO - NOTNLM
OT  - chronic kidney disease
OT  - diabetic kidney disease
OT  - gender
OT  - real-world data
OT  - underdiagnosis
EDAT- 2022/09/27 06:00
MHDA- 2022/09/27 06:01
PMCR- 2022/04/14
CRDT- 2022/09/26 17:16
PHST- 2021/12/23 00:00 [received]
PHST- 2022/09/26 17:16 [entrez]
PHST- 2022/09/27 06:00 [pubmed]
PHST- 2022/09/27 06:01 [medline]
PHST- 2022/04/14 00:00 [pmc-release]
AID - sfac100 [pii]
AID - 10.1093/ckj/sfac100 [doi]
PST - epublish
SO  - Clin Kidney J. 2022 Apr 14;15(10):1865-1871. doi: 10.1093/ckj/sfac100. 
      eCollection 2022 Oct.