ESTIMATING GLOMERULAR FILTRATION RATE IN PRIMARY CARE ELECTRONIC MEDICAL RECORD DATABASES IN EUROPE

• Published in: Value in health Vol. 20; no. 5; p. A313
• Main Authors: Jouaville, SL, Bizouard, G, Boutmy, E, Keja, J
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.05.2017
• Subjects: Blood; Creatinine; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diet; Electronic health records; Electronic medical records; Epidermal growth factor receptors; Glomerular filtration rate; Health authorities; Kidney diseases; Kidneys; Patients; Physicians; Prescribing; Primary care; Race; Renal failure; Serum; Type 2 diabetes mellitus; Europe
• ISSN: 1098-3015; 1524-4733

OBJECTIVES: Chronic kidney disease (CKD) prevalence is increasing, partially as a consequence of the increasing diabetes prevalence, and is rightly increasingly watched by health authorities. The estimated glomerular filtration rate (eGFR) is used to monitor kidney status. It is a calculation based on the results of a blood creatinine test along with other variables such as age, sex, and race, depending on the equation used. The aim of this study was to compare eGFR values calculated with the use of Cockcroft & Gault formula (CG) and Simplified Modification of Diet in Renal Diseases (sMDRD) in European electronic medical record (EMR)-data-bases METHODS: This study used data from QuintilesIMS EMR-databases which are EMR and prescribing databases of primary care physicians in community-based, fee for-service practices in the UK and Germany. Frequency of renal impairment based on eGFR was estimated using both CG and sMDRD equations on a cohort patients with type 2 diabetes (T2D) receiving a glifozin treatment. Diagnoses for renal failure were also retrieved. RESULTS: A cohort of over 8000 and 1700 of glifozin-treated T2D patients in the UK and Germany respectively were assessed for kidney status. Creatinine serum test were available for 95% and 75% of patients in the UK and Germany respectively. eGFR with CG formula could be calculated for 90% and 30% of patients in the UK and Germany respectively, while it was available for 95% (UK) and 75% (Germany) of patients using sMDRD. The eGFR values varied depending on the formula used. A higher proportion of patients with moderate and severe renal impairment were retrieved using sMDRD. CONCLUSIONS: In agreement with previous works we found that CG formula tends to overestimate eGFR value. We recommend the use of SMDRD in European EMR- databases for calculation of eGFR.