Kidney Week

Abstract: SA-PO1118

Concordance Between Laboratory- and ICD-10 Code-Defined Stages of CKD Among Patients Hospitalized with Heart Failure in a Large US Integrated Health System

Session Information

• CKD Epidemiology, Risk Factors, Prevention - III
  November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Granowitz, Craig, Lexicon Pharmaceuticals Inc, The Woodlands, Texas, United States

Craig Granowitz,

• Li, Hsin-Fang, Providence Heart Institute, Center for Cardiovascular Analytics, Research and Data Science, Portland, Oregon, United States

Hsin-Fang Li,

• Chiu, Shihting, Providence Heart Institute, Center for Cardiovascular Analytics, Research and Data Science, Portland, Oregon, United States

Shihting Chiu,

• Rider, Deanna, Providence St Joseph Health, Renton, Washington, United States

Deanna Rider,

• Tseng, Phil, Banner University Medical Center Tucson, Tucson, Arizona, United States

Phil Tseng,

• Mudd, James, Providence St Joseph Health, Renton, Washington, United States

James Mudd,

• Remick, Joshua David, Providence St Joseph Health, Renton, Washington, United States

Joshua David Remick,

• Sikirica, Slaven, Lexicon Pharmaceuticals Inc, The Woodlands, Texas, United States

Slaven Sikirica,

• Carroll, Amy K., Lexicon Pharmaceuticals Inc, The Woodlands, Texas, United States

Amy K. Carroll,

• Canonico, Mario Enrico, University of Colorado, Denver, Colorado, United States

Mario Enrico Canonico,

• Hsia, Judith, University of Colorado, Denver, Colorado, United States

Judith Hsia,

• Bonaca, Marc P., University of Colorado, Denver, Colorado, United States

Marc P. Bonaca,

• Gluckman, Ty, Providence St Joseph Health, Renton, Washington, United States

Ty Gluckman,

Background

The presence of chronic kidney disease (CKD) in patients with heart failure (HF) conveys increased cardiovascular risk, while informing use of some forms of guideline-directed medical therapy. Accordingly, we sought to better understand the level of concordance between laboratory-and ICD-10 code-defined stages of non-dialysis-dependent CKD in this population.

Methods

We performed a retrospective cross-sectional analysis of patients admitted to a large integrated health system within the western US between January 1, 2018 and October 1, 2022 with a principal diagnosis of HF (defined by ICD-10 codes: I50.2, systolic heart failure; I50.3, diastolic heart failure; I50.4, combined systolic and diastolic heart failure; I11.0, hypertensive heart disease with heart failure; and I13.0 and I13.2, hypertensive heart disease with heart failure and CKD). CKD was assessed using pre-discharge laboratory data (based on the 2021 CKD-EPI equation) as well as ICD-10 codes.

Results

Over nearly 5 years, 61,238 HF hospitalizations occurred, involving 43,234 patients, with 94% having a serum creatinine available. Stage 3a, 3b, 4, and 5 CKD was noted in 21%, 22%, 17%, and 11% of hospitalized patients, respectively, based on laboratory data (Table). Among patients with an ICD-10 code for stage 3-5 CKD, rates of concordance with laboratory-defined CKD rose from 6% to 80% (Table and Figure) as renal function worsened.

Conclusion

Concordance between laboratory- and ICD-10 code defined stages of CKD rose as CKD severity increased.

Relationship between CKD severity by laboratory data and ICD-10 codes

Relationship between CKD severity by laboratory data and ICD-10 codes

Funding

• Commercial Support – Lexicon Pharmaceuticals, Inc.