Missed Opportunities for Chronic Kidney Disease Recognition in Irish Primary Care: A Nationwide Electronic Health Record Study
Authors: B. M. Jacob, K. Eyers, M. M. Hayes, H. Dickinson, D. Jin, A. Coughlan, E. Ryan, B. van Hecke, P. Redmond, A. Stack, D. J. Sexton, D. Bailey
Abstract
ObjectivesTo examine chronic kidney disease (CKD) diagnostic coding in Irish primary care using electronic health records (EHRs). MethodsThis retrospective cohort study used EHR data from 592,888 active patients across 66 Irish primary care practices. Adults aged [≥]20 years meeting laboratory-based CKD criteria were identified. CKD coding was defined by the presence of an ICD-10 or ICPC-2 diagnosis code. Coding rates were evaluated overall and by CKD stages, comorbidities, and practices. ResultsAmong 19,382 adults with laboratory-confirmed CKD (median age 76 years; 55.7% female), 14.6% had a documented CKD diagnosis code. Coding increased with disease severity, from 4.8% in stages 1-2 to 19.6% in stages 3-5, and varied by comorbidity burden, with only 10.1% of patients without major cardiometabolic comorbidities coded. Substantial practice-level variation was observed, with over half of practices (34/61) recording coding rates below 10%, while four exceeded 40%. Most patients (85.4%) remained uncoded throughout follow-up. ConclusionsThis first nationwide study of CKD coding in Irish primary care network demonstrates substantial under-coding despite laboratory evidence, with marked variation between practices. Improving coding consistency and completeness may enhance CKD recognition, support earlier intervention, and improve patient outcomes.
The papers around it, by date and closeness
Higher is closer to this paper; left is older. Lines join papers close to each other: groups of lines are sub-topics. Select a point to see why it is there. Back to the summary of this paper
Papers around this one
Ranked by how close their title and abstract are to this paper’s. Select some to read them together.
Closest papers
-
Multi-level clinical inertia in chronic kidney disease management in primary care: A retrospective cross-sectional analysis of coding, reclassification and risk stratification.A. Zafar, C. Scarlata, A. Saeed et al. · 2026 · Primary Care Diabetes · Not summarized yet
Multi-level clinical inertia examines CKD coding and risk stratification in primary-care records, focusing on adults with coded CKD.
Abstract
AIMS/HYPOTHESIS Accurate coding, longitudinal stage review and complete risk stratification underpin chronic kidney disease (CKD) care in primary care, especially in people with diabetes, where CKD modifies cardiovascular risk, prescribing safety and referral thresholds. We hypothesised that, beyond well-described inertia in pharmacological treatment intensification, primary care records would also exhibit inertia in diagnostic coding, longitudinal reclassification and albuminuria-based risk stratification, clustering with higher kidney and cardiovascular risk. METHODS We performed a retrospective cross-sectional analysis of adult primary care records with coded CKD. The latest estimated glo…
-
Prevalence and Management of Chronic Kidney Disease in Irish Primary Care NetworkB. Jacob, K. Eyers, D. Jin et al. · 2026 · medRxiv · preprint, not peer reviewed · Not summarized yet
Prevalence and Management examines CKD prevalence and care in the Irish Primary Care Network, the same setting and disease.
-
B-285 Underdiagnosis and Gaps in Guideline-Recommended Testing for Chronic Kidney Disease in an Academic Health System: A Population-Based Race, Ethnicity, Language, and Sex AnalysisZheng-Chun Lu, Y. Lyu, Siouxzanna Downs et al. · 2026 · Clinical Chemistry · Not summarized yet
B-285 measures CKD underdiagnosis and testing gaps in a health system, examining recognition among patients assessed under CKD guidelines.
Abstract
Chronic kidney disease (CKD) is underdiagnosed, and adherence to National Kidney Foundation (NKF) screening recommendations among high-risk patients remains suboptimal. NKF guidelines recommend annual assessment with both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR) among patients with diabetes or hypertension. We evaluated CKD diagnosis, risk burden, and testing gaps using the NKF CKD framework, stratified by race, ethnicity, language, and sex variables. We conducted a retrospective population-based analysis of 407,894 adults aged 18–85 years with at least one clinical encounter in the Oregon Health & Science University (OHSU) health system betwee…
-
Prevalence, risk factors and renoprotective treatment of chronic kidney disease among internal medicine outpatients at a Central European tertiary care centre: a cross-sectional studyI. Zahradka, V. Petr, F. Tichanek et al. · 2026 · BMJ Open · Not summarized yet
The outpatient study assesses CKD prevalence, risk factors, and renoprotective treatment in a Central European tertiary-care setting.
Abstract
Abstract Objectives To determine the prevalence of chronic kidney disease (CKD) in internal medicine outpatients in a Central European tertiary care setting, identify associated risk factors and assess use and potential impact of renoprotective therapies. We hypothesised that CKD is common, underdiagnosed and undertreated. Design Cross-sectional observational study. Setting Tertiary care outpatient clinics in Central Europe. Participants 1933 adult outpatients at risk for CKD were screened; an expanded cohort of 2903 patients with available laboratory data was included for secondary analyses. Inclusion required assessment of estimated glomerular filtration rate (eGFR) and urine albumin-creat…
-
Prevalence and significance of family history of kidney disease in the electronic health record in three United States health systems.Andrei Bucaloiu, Aditya L. Surapaneni, Sneha S. Mehta et al. · 2026 · Kidney International · Not summarized yet
The family-history study examines kidney disease documentation in EHRs, but focuses on family history rather than patients' CKD diagnosis coding.
Abstract
INTRODUCTION Family history is a key predictor of chronic kidney disease (CKD) and kidney failure, yet its documentation in electronic health records (EHRs) remains poorly characterized. Here, we examined the prevalence of kidney-related family history across three large United States. health systems and assessed associations with kidney disease outcomes. METHODS We conducted a cross-sectional study of 1,130,961 adults (age 18-80) receiving primary care at Geisinger, New York University Langone Health, and University of Utah Health from 2020-2023. Family history of CKD and kidney failure was ascertained from structured EHR fields and relevant search terms in comments in the family history se…
-
Ethnic inequalities in kidney function and progression to advanced CKD in T2D: a primary care studyT. Alobaid, J. Karalliedde, M. O'Connell et al. · 2026 · European Journal of Public Health · Not summarized yet
The T2D study tracks ethnic differences in kidney-function trajectories and progression to advanced CKD in primary care.
Abstract
Abstract Background Chronic kidney disease (CKD) is a major complication of type 2 diabetes (T2D) and a key contributor to health inequalities. Patterns of kidney function decline are heterogeneous, yet little is known about how these trajectories differ across ethnic groups in primary care settings. Understanding early divergence in risk is essential for prevention and equitable care. Methods We conducted a retrospective cohort study using Lambeth DataNet, London, UK, including 24,716 adults with T2D and ≥2 eGFR measurements (2004–2018). Group-based trajectory modelling identified distinct kidney function patterns. Multinomial logistic regression examined determinants of trajectory membersh…
-
Prevalence of Undertreated CKD among Hospital Inpatients: A Prospective Cross-Sectional Study.L. Wynter, Brendan Smyth, John Saunders et al. · 2026 · Kidney360 · Not summarized yet
The inpatient study concerns undertreated CKD in hospitals rather than diagnosis coding in primary care.
-
Comprehensive trends in Chronic Kidney Disease prevalence and comorbidities across eGFR and albuminuria categories: a 20-year analysis of NHANES dataYoussef M. K. Farag, Zi-He Zheng, Aqsa H. Dar et al. · 2026 · Renal Failure · Not summarized yet
The NHANES analysis tracks CKD prevalence and comorbidities across eGFR and albuminuria categories in the United States.
Abstract
Abstract Chronic kidney disease (CKD) represents a major public health challenge, contributing to over 1.2 million global deaths annually and ranking as the 12th leading cause of mortality. This study provides a 20-year trend analysis (1999–2018) of CKD prevalence and its associated comorbidities among adults in the United States using the NHANES dataset. Employing the CKD-EPI 2021 equation without the race component, the study revealed a stable CKD prevalence of 20% in adults aged ≥20 years, alongside trends in nine comorbidities. Obesity and diabetes showed significant increases, while hypertension, anemia, hyperkalemia, and cardiovascular disease remained stable. Hypertriglyceridemia and …
Go further
How are these papers found?
We compare the title and abstract of this paper with those of every paper summarized on this site, and with the papers Semantic Scholar recommends, those it cites and those citing it (for a much-cited paper, its most recent citations and, from OpenAlex, the most cited ones). Among the prior work and the follow-ups, the papers that use each other in depth, a method it uses and the much-cited follow-ups come a little higher. The levels (very close, close, related) come from the similarity of the texts, not from a judgment of quality; * marks a paper without an abstract, compared by its title. The sentence under a paper is written by an AI from the two abstracts: check it in the papers. A paper marked not relevant by three readers leaves the list.
Updated on 2 November 2026.