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Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

277
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
277
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
182
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

36
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
36
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

148
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
148
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

98
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
98
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

98
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Updated: Oct 23, 2025

Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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CKD Prevalence in the Military Health System: Coded Versus Uncoded CKD.

Jenna M Norton1, Lindsay Grunwald2, Amanda Banaag2

  • 1Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD.

Kidney Medicine
|August 17, 2021
PubMed
Summary
This summary is machine-generated.

Chronic kidney disease (CKD) is often unrecorded in the Military Health System (MHS). Uncoded CKD disproportionately affects younger, female, and active-duty beneficiaries, suggesting potential gaps in care for lower-risk groups.

Keywords:
Chronic kidney diseasechronic renal diseasechronic renal insufficiencyelectronic health recordelectronic phenotypeestimated glomerular filtration ratemedical recordproteinuria

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Area of Science:

  • Nephrology
  • Public Health
  • Health Informatics

Background:

  • Chronic kidney disease (CKD) is a prevalent condition that is frequently underdiagnosed or unrecorded in administrative datasets.
  • Accurate identification of CKD is crucial for timely intervention and management to prevent disease progression.

Purpose of the Study:

  • To determine the prevalence of CKD within the Military Health System (MHS) using both diagnostic codes and an electronic health record-based phenotype.
  • To compare the characteristics of beneficiaries with coded versus uncoded CKD to identify potential disparities in diagnosis.

Main Methods:

  • A cross-sectional study was conducted using data from MHS beneficiaries aged 18 to 64 years from fiscal years 2016 to 2018.
  • CKD was defined using International Classification of Diseases, Tenth Revision (ICD-10) codes and/or a validated electronic phenotype incorporating estimated glomerular filtration rate and proteinuria.
  • Statistical analyses, including t-tests and chi-squared tests, were used to compare coded and uncoded CKD populations based on demographic and clinical predictors.

Main Results:

  • The MHS population comprised 3,330,893 beneficiaries, with an overall CKD prevalence of 3.2%.
  • A significant proportion (63%) of CKD cases were identified through the electronic phenotype without an ICD-10 code (uncoded CKD).
  • Beneficiaries with uncoded CKD were younger, more often female and active duty, and less likely to have diabetes or hypertension compared to those with coded CKD.

Conclusions:

  • The findings suggest that CKD is under-recorded in the MHS, with a substantial number of cases identified only through electronic phenotyping.
  • Individuals with traditionally lower CKD risk factors (e.g., younger age, female sex) were more likely to have uncoded CKD, indicating potential missed diagnoses in these groups.
  • The study highlights the importance of utilizing comprehensive phenotyping methods beyond simple diagnostic codes to accurately capture CKD prevalence and ensure equitable care.