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The following is a summary of “Uncoded chronic kidney disease prevalence in secondary care: a retrospective audit with population health implications,” published in the January 2025 issue of Nephrology by Dolan et al.
An estimated 1 million patients in England have undiagnosed chronic kidney disease (CKD). While primary care coding improves CKD management, evidence on coding quality in secondary care is limited.
Researchers conducted a retrospective study to measure the prevalence of coded and uncoded CKD in secondary care and to identify predictors of coding, death, and acute kidney injury (AKI) while mapping coding status to health inequality themes.
They conducted a retrospective audit in an acute medical hospital ward (April 2022–February 2023), using descriptive statistics for counts, percentages, prevalence, and rates. Logistic regression identified predictors (P < 0.05) of diagnostic CKD coding on discharge, death risk, and AKI.
The results showed uncoded CKD prevalence was 58.7% (n = 283), equating to 1.1 cases per bed/month and 13.7 cases per bed/year. Conversion to coded CKD at discharge was 6.7%. Hypertension and advanced CKD were significant predictors of CKD coding, while age, sex, deprivation indices, and AKI predicted death, and advanced CKD predicted AKI.
Investigators found that uncoded CKD was highly prevalent in an acute medical hospital ward, indicating an opportunity to improve coding in secondary care alongside primary care. Enhancing CKD coding could improve patient management and outcomes.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-03967-x
