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

Area of Science:

• Nephrology
• Epidemiology
• Health Informatics

Background:

• Electronic health records (EHRs) provide extensive data for kidney disease research, including serum creatinine and urinary albumin.
• Healthcare utilization and lab testing frequency vary by patient health status, complicating kidney disease research.
• Existing definitions of kidney disease in research lack uniformity, impacting study validity and generalizability.

Purpose of the Study:

• To review the heterogeneity of kidney disease definitions in scientific literature.
• To discuss the advantages and limitations of common approaches in kidney disease research.
• To propose a framework for reporting exposures and outcomes in kidney disease studies using routine health data.

Main Methods:

• Literature review of working definitions for kidney disease.
• Analysis of common approaches with three illustrative examples.
• Summary of methods to identify and mitigate biases in observational studies.

Main Results:

• Significant heterogeneity exists in defining kidney disease and its outcomes in research.
• Common methods for defining kidney disease present specific advantages and limitations.
• Biases related to healthcare utilization and testing frequency can impact study findings.

Conclusions:

• Standardized reporting of definitions for exposures and outcomes is crucial for kidney disease research using EHRs.
• Addressing biases related to data collection is essential for accurate interpretation of kidney disease studies.
• A proposed framework can enhance the validity and reproducibility of research on kidney disease using routinely collected health data.