Chronic kidney disease (CKD) often progresses without noticeable symptoms, leaving many people unaware that they have the condition. An estimated 35.5 million U.S. adults have CKD, and most do not know it. Although CKD has no cure, earlier detection and appropriate treatment can help slow progression, reduce cardiovascular risk and delay kidney failure.
To slow progression to kidney failure for the millions of U.S. adults living with CKD, researchers need to understand how kidney function, albuminuria, treatment and comorbid conditions change over time.
HealthVerity taXonomy Pathways includes a research-ready cohort of more than 10.7 million patients with CKD. The cohort combines longitudinal claims, lab and electronic health record data to help researchers examine diagnosis, disease progression, treatment patterns and outcomes across the patient journey.
By integrating claims with longitudinal lab and EHR data, researchers can identify patients whose kidney function or albuminuria results suggest CKD, including patients who may not yet have a corresponding diagnosis in claims. The cohort spans multiple payer types and incorporates claims, lab and EHR data. More than 6.6 million patients have over three years of enrollment, supporting extended analysis of disease progression with greater confidence in longitudinal data capture. Approximately 3.3 million patients have data available across the patient journey.
EHR and lab data add clinical measurements that claims alone cannot provide, including estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (uACR), hemoglobin A1c, body mass index, blood pressure and social history. This research-ready CKD cohort can reduce dataset preparation and help teams move more quickly from study design to analysis.
RESEARCHERS CAN:
- Assess trial feasibility and identify participants based on diagnosis history, comorbidities, treatment exposure and clinical measurements such as eGFR, uACR and hemoglobin A1c
- Seamlessly sync clinical trial participants with their RWD for a longitudinal view of their journey to CKD and potential health events occurring outside of the study
- Quickly conduct a control arm or concurrent study to respond to new questions that may arise, changes in care and contextualize your research
- Continually monitor trial participants to future proof your study and understand the ongoing safety and efficacy after a product is in market
Understanding how a CKD patient progresses from one stage to the next is important for developing appropriate treatments and RWD can shed light on this journey. Here is one example of a patient journey that might be uncovered:
Pre-CKD but at risk
Medical claims, lab data and EMR find a patient having an annual wellness visit with their primary care physician. The patient has an eGFR of 64, which falls within the G2 range. A single result does not establish CKD. Persistent kidney damage, such as elevated uACR, structural abnormalities or an eGFR below 60 for at least three months, would support a CKD diagnosis. Obesity and dyslipidemia may increase the patient’s future risk.
Decline detected
At the next annual wellness visit, the patient has a new diagnosis of hypertension and an eGFR of 60. Longitudinal eGFR results, uACR measurements and clinical notes can help researchers determine whether this represents sustained decline, expected variation or emerging CKD.
CKD diagnosed
Later, medical claims, EMR and lab data show that the patient saw a nephrologist for diagnostic testing and experienced significant decline. Repeated results show an eGFR near 46 for at least three months, placing the patient in CKD stage 3a. uACR results and physician notes provide additional context on kidney damage, progression risk and the distinction between CKD and an acute kidney injury.
Protecting the kidneys
With CKD increasing the risk of heart disease and the need to manage the patient’s related hypertension to protect the kidneys, the patient is referred to a cardiologist. Longitudinal claims, EHR and lab data reveal a coronary artery disease diagnosis and an eGFR of 40, which falls within stage 3b. Treatment records and physician notes can help researchers understand how the care team manages cardiovascular and kidney risk together. At this stage, the patient is prescribed a cardiac medication.
Further progression
Follow-up results show an eGFR of 34, placing the patient in stage 3b CKD. A uACR greater than 300 mg/g would indicate severely increased albuminuria and a higher risk of progression. As kidney function declines toward stage 4, the care team may begin education and planning for kidney replacement therapy based on the patient’s broader clinical status.
End stage renal disease
Claims and hospital data show an unplanned hospitalization followed by urgent dialysis initiation. Because the patient did not have permanent vascular access in place, the record may indicate greater risk of catheter-related infection and other complications. With an eGFR of 11 and the initiation of dialysis, the patient has reached stage 5 CKD, or kidney failure. Without a permanent vascular access solution in place due to the emergency start of dialysis, the patient is at greater risk for infection and other complications.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)1 is encouraging people to follow their kidney health to better understand their risks of CKD and protect them from further damage.
taXonomy Pathways combines claims, lab and EHR data in a research-ready CKD cohort, helping teams evaluate disease progression, treatment decisions and outcomes across a longitudinal patient journey. With more than 10.7 million patients and extensive repeated clinical measurements, researchers can move from cohort definition to evidence generation with greater speed and clinical depth. Contact us to explore your CKD request.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). https://www.niddk.nih.gov/health-information/community-health-outreach/national-kidney-month