ArticleClinical kidney journal2021
Influence of doctors' perception on the diagnostic status of chronic kidney disease: results from 976 409 individuals with electronic health records in China.
Article in Clinical kidney journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 16 citations in OpenAlex.
- Clinical Decision Support for Chronic Kidney Disease in Primary Care: A Cluster Randomized Clinical Trial.JAMA network open · 2026Trial
- Identification and regulatory mechanism analysis of macrophage-related key genes in diabetic nephropathy.Diabetology & metabolic syndrome · 2026Article
- Clinical and Financial Impacts of Late Referral in Patients With Chronic Kidney Disease: A Narrative Review.Cureus · 2025Review
- Predicting kidney replacement therapy, cardiovascular disease and all-cause mortality in advanced chronic kidney disease among the Chinese population.Renal failure · 2025Article
- Development and validation of identification algorithms for five autoimmune diseases using electronic health records: a retrospective cohort study in China.Frontiers in immunology · 2025Article
- Monitoring the safety of the adjuvanted human papillomavirus vaccine, HPV-16/18-AS04: Protocol for a cohort study using electronic health records in Yinzhou, China.Human vaccines & immunotherapeutics · 2024Article
- External Validation of the Kidney Failure Risk Equation Among Urban Community-Based Chinese Patients With CKD.Kidney medicine · 2024Article
- Misdiagnosis of chronic kidney disease and parathyroid hormone testing during the past 16 years.Scientific reports · 2023Article
- MOnitoring human papillomavirus Vaccine effect on Infection and cErvical diseases (MOVIE): Protocol for a cohort study using electronic health records from Yinzhou, China.Human vaccines & immunotherapeutics · 2023Article
- Chronic kidney disease as cardiovascular risk factor in routine clinical practice: a position statement by the Council of the European Renal Association.Clinical kidney journal · 2023Article
- Chronic kidney disease as cardiovascular risk factor in routine clinical practice: a position statement by the Council of the European Renal Association.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Transforming Health Care Through a Learning Health System Approach in the Digital Era: Chronic Kidney Disease Management in China.Health data science · 2023Review
- Benchmarking CKD: incidence of CKD in a European country with low prevalence of CKD and kidney replacement therapy.Clinical kidney journal · 2022Article
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Authors and funding
13 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe diagnostic status of chronic kidney disease (CKD) and its underlying reasons provide evidence that can improve CKD management. However, the situation in developing countries remains under-investigated.
methodsAdults with electronic health records (EHRs; 2008-19) in Yinzhou, China were included. The gold standard for CKD was defined as having persistently reduced estimated glomerular filtration rate (eGFR), albuminuria/proteinuria, haematuria or a history of CKD. CKD stages (G1-G5) were defined by eGFR. Clinical diagnosis of CKD in the real world setting was evaluated using International Classification of Diseases (ICD)-10 codes related to primary cause or stages of CKD. The specialty of doctors who administered the serum creatinine (SCr) tests and who made the primary-cause/CKD-staging diagnoses was analysed. The accuracy of CKD-staging codes was assessed.
resultsAltogether, 85 519 CKD patients were identified from 976 409 individuals with EHRs. Of them, 10 287 (12.0%) having persistent urinary abnormalities or labelled with CKD-related ICD codes did not receive SCr tests within 12 months before or after the urine tests. Among 75 147 patients who received SCr tests, 46 150 (61.4%) missed any CKD-related codes, 6857 (35.7%) were merely labelled with primary-cause codes, and only 2140 (2.9%) were labelled with CKD-staging codes. The majority of CKD patients (51.6-91.1%) received SCr tests from non-nephrologists, whereas CKD-staging diagnoses were mainly from nephrologists (52.3-64.8%). Only 3 of 42 general hospitals had nephrologists. The CKD-staging codes had high specificity (>99.0%) but low sensitivity (G3-G4: <10.0%).
conclusionsUnder-perception of CKD among doctors, rather than unsatisfactory health-seeking behaviour or low detection rates, was the main cause of under-diagnosis of CKD in China. Intensification of CKD education among doctors with different specialties might bring about immediate effective improvement in the diagnosis and awareness of CKD.
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