Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations

Juan Jesus Carrero; Edouard L. Fu; S. ren V. Vestergaard; Simon Kok Jensen; Alessandro Gasparini; Viyaasan Mahalingasivam; Samira Bell; Henrik Birn; Uffe Heide-Jørgensen; Catherine M. Clase; Faye Cleary; Josef Coresh; Friedo W. Dekker; Ron T. Gansevoort; Brenda R. Hemmelgarn; Kitty J. Jager; Tazeen H. Jafar; Csaba P. Kovesdy; Manish M. Sood; B. nédicte Stengel; Christian F. Christiansen; Masao Iwagami; Dorothea Nitsch

doi:10.1016/j.kint.2022.09.020

Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations

Juan Jesus Carrero^*
, Edouard L. Fu
, S. ren V. Vestergaard
, Simon Kok Jensen
, Alessandro Gasparini
, Viyaasan Mahalingasivam
, Samira Bell
, Henrik Birn
, Uffe Heide-Jørgensen
, Catherine M. Clase
, Faye Cleary
, Josef Coresh
, Friedo W. Dekker
, Ron T. Gansevoort
, Brenda R. Hemmelgarn
, Kitty J. Jager
, Tazeen H. Jafar
, Csaba P. Kovesdy
, Manish M. Sood
, B. nédicte Stengel

Christian F. Christiansen, Masao Iwagami, Dorothea Nitsch^*

^*Corresponding author for this work

Karolinska Institutet
Harvard University
Leiden University Medical Center
Aarhus University
London School of Hygiene and Tropical Medicine
School of Medicine Centre for Cardiovascular and Lung Biology, Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
McMaster University
Johns Hopkins University
University of Groningen, University Medical Center Groningen
Department of Medicine and Clinical Islet Transplant Program, University of Alberta, Edmonton, AB, Canada
Amsterdam Public Health
Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
University of Tennessee Health Science Center
University of Ottawa
Université Paris-Sud
University of Tsukuba
Chiang Mai University
UK Renal Registry

Research output: Contribution to journal › Review article › Academic › peer-review

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Abstract

The availability of electronic health records and access to a large number of routine measurements of serum creatinine and urinary albumin enhance the possibilities for epidemiologic research in kidney disease. However, the frequency of health care use and laboratory testing is determined by health status and indication, imposing certain challenges when identifying patients with kidney injury or disease, when using markers of kidney function as covariates, or when evaluating kidney outcomes. Depending on the specific research question, this may influence the interpretation, generalizability, and/or validity of study results. This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using 3 examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected health care data.

Original language	English
Pages (from-to)	53-69
Number of pages	17
Journal	Kidney international
Volume	103
Issue number	1
Early online date	2022
DOIs	https://doi.org/10.1016/j.kint.2022.09.020
Publication status	Published - Jan 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

albuminuria
chronic kidney disease (CKD)
creatinine
epidemiology
estimated glomerular filtration rate (eGFR)
routinely collected health care data

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10.1016/j.kint.2022.09.020

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Carrero, J. J., Fu, E. L., Vestergaard, S. R. V., Jensen, S. K., Gasparini, A., Mahalingasivam, V., Bell, S., Birn, H., Heide-Jørgensen, U., Clase, C. M., Cleary, F., Coresh, J., Dekker, F. W., Gansevoort, R. T., Hemmelgarn, B. R., Jager, K. J., Jafar, T. H., Kovesdy, C. P., Sood, M. M., ... Nitsch, D. (2023). Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations. Kidney international, 103(1), 53-69. https://doi.org/10.1016/j.kint.2022.09.020

@article{7d39b22732ca4a1ea22b99cf918ca6d3,

title = "Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations",

abstract = "The availability of electronic health records and access to a large number of routine measurements of serum creatinine and urinary albumin enhance the possibilities for epidemiologic research in kidney disease. However, the frequency of health care use and laboratory testing is determined by health status and indication, imposing certain challenges when identifying patients with kidney injury or disease, when using markers of kidney function as covariates, or when evaluating kidney outcomes. Depending on the specific research question, this may influence the interpretation, generalizability, and/or validity of study results. This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using 3 examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected health care data.",

keywords = "albuminuria, chronic kidney disease (CKD), creatinine, epidemiology, estimated glomerular filtration rate (eGFR), routinely collected health care data",

author = "Carrero, \{Juan Jesus\} and Fu, \{Edouard L.\} and Vestergaard, \{S. ren V.\} and Jensen, \{Simon Kok\} and Alessandro Gasparini and Viyaasan Mahalingasivam and Samira Bell and Henrik Birn and Uffe Heide-J{\o}rgensen and Clase, \{Catherine M.\} and Faye Cleary and Josef Coresh and Dekker, \{Friedo W.\} and Gansevoort, \{Ron T.\} and Hemmelgarn, \{Brenda R.\} and Jager, \{Kitty J.\} and Jafar, \{Tazeen H.\} and Kovesdy, \{Csaba P.\} and Sood, \{Manish M.\} and Stengel, \{B. n{\'e}dicte\} and Christiansen, \{Christian F.\} and Masao Iwagami and Dorothea Nitsch",

note = "Funding Information: JJC acknowledges support from the Swedish Research Council. ELF acknowledges support by a Rubicon Grant of the Netherlands Organization for Scientific Research (NWO). MMS is funded by the Jindal Research Chair for the Prevention of Kidney Disease. CFC acknowledges support from the Independent Research Fund Denmark. VM is funded by the National Institutes for Health and Care Research (NIHR). FC is funded by the Medical Research Council (MR/N013638/1). JC acknowledges support from the National Institutes of Health and US National Kidney Foundation. Publisher Copyright: {\textcopyright} 2022 International Society of Nephrology",

year = "2023",

month = jan,

doi = "10.1016/j.kint.2022.09.020",

language = "English",

volume = "103",

pages = "53--69",

journal = "Kidney international",

issn = "0085-2538",

publisher = "Nature Publishing Group",

number = "1",

}

Carrero, JJ, Fu, EL, Vestergaard, SRV, Jensen, SK, Gasparini, A, Mahalingasivam, V, Bell, S, Birn, H, Heide-Jørgensen, U, Clase, CM, Cleary, F, Coresh, J, Dekker, FW, Gansevoort, RT, Hemmelgarn, BR, Jager, KJ, Jafar, TH, Kovesdy, CP, Sood, MM, Stengel, BN, Christiansen, CF, Iwagami, M & Nitsch, D 2023, 'Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations', Kidney international, vol. 103, no. 1, pp. 53-69. https://doi.org/10.1016/j.kint.2022.09.020

TY - JOUR

T1 - Defining measures of kidney function in observational studies using routine health care data

T2 - methodological and reporting considerations

AU - Carrero, Juan Jesus

AU - Fu, Edouard L.

AU - Vestergaard, S. ren V.

AU - Jensen, Simon Kok

AU - Gasparini, Alessandro

AU - Mahalingasivam, Viyaasan

AU - Bell, Samira

AU - Birn, Henrik

AU - Heide-Jørgensen, Uffe

AU - Clase, Catherine M.

AU - Cleary, Faye

AU - Coresh, Josef

AU - Dekker, Friedo W.

AU - Gansevoort, Ron T.

AU - Hemmelgarn, Brenda R.

AU - Jager, Kitty J.

AU - Jafar, Tazeen H.

AU - Kovesdy, Csaba P.

AU - Sood, Manish M.

AU - Stengel, B. nédicte

AU - Christiansen, Christian F.

AU - Iwagami, Masao

AU - Nitsch, Dorothea

N1 - Funding Information: JJC acknowledges support from the Swedish Research Council. ELF acknowledges support by a Rubicon Grant of the Netherlands Organization for Scientific Research (NWO). MMS is funded by the Jindal Research Chair for the Prevention of Kidney Disease. CFC acknowledges support from the Independent Research Fund Denmark. VM is funded by the National Institutes for Health and Care Research (NIHR). FC is funded by the Medical Research Council (MR/N013638/1). JC acknowledges support from the National Institutes of Health and US National Kidney Foundation. Publisher Copyright: © 2022 International Society of Nephrology

PY - 2023/1

Y1 - 2023/1

N2 - The availability of electronic health records and access to a large number of routine measurements of serum creatinine and urinary albumin enhance the possibilities for epidemiologic research in kidney disease. However, the frequency of health care use and laboratory testing is determined by health status and indication, imposing certain challenges when identifying patients with kidney injury or disease, when using markers of kidney function as covariates, or when evaluating kidney outcomes. Depending on the specific research question, this may influence the interpretation, generalizability, and/or validity of study results. This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using 3 examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected health care data.

AB - The availability of electronic health records and access to a large number of routine measurements of serum creatinine and urinary albumin enhance the possibilities for epidemiologic research in kidney disease. However, the frequency of health care use and laboratory testing is determined by health status and indication, imposing certain challenges when identifying patients with kidney injury or disease, when using markers of kidney function as covariates, or when evaluating kidney outcomes. Depending on the specific research question, this may influence the interpretation, generalizability, and/or validity of study results. This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using 3 examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected health care data.

KW - albuminuria

KW - chronic kidney disease (CKD)

KW - creatinine

KW - epidemiology

KW - estimated glomerular filtration rate (eGFR)

KW - routinely collected health care data

UR - https://www.scopus.com/pages/publications/85142190301

U2 - 10.1016/j.kint.2022.09.020

DO - 10.1016/j.kint.2022.09.020

M3 - Review article

C2 - 36280224

SN - 0085-2538

VL - 103

SP - 53

EP - 69

JO - Kidney international

JF - Kidney international

IS - 1

ER -

Defining measures of kidney function in observational studies using routine health care data: methodological and reporting considerations

Abstract

UN SDGs

Keywords

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