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Diagnostics
Volume 14
Issue 22
10.3390/diagnostics14222476
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Article

Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study

by
Olga Endrich
1,2,3,*,
Christos T. Nakas
2,4,
Karen Triep
1,
Georg M. Fiedler
2,
Jaime J. Caro
3,5 and
Alistair McGuire
3
1
Medical Directorate, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
2
University Institute of Clinical Chemistry, University of Bern, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
3
Department of Health Policy, London School of Economics, London WC2A 2AE, UK
4
Laboratory of Biometry, University of Thessaly, 38446 Volos, Greece
5
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC H3A 1G1, Canada
*
Author to whom correspondence should be addressed.
Diagnostics 2024, 14(22), 2476; https://doi.org/10.3390/diagnostics14222476
Submission received: 8 October 2024 / Revised: 29 October 2024 / Accepted: 3 November 2024 / Published: 6 November 2024
(This article belongs to the Special Issue Diagnosis and Treatment of Kidney Disease)
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Abstract

(1) Background: “Kidney Disease: Improving Global Outcomes” (KDIGO) provides guidelines for identifying the stages of acute kidney injury (AKI) and chronic kidney disease (CKD). A data-driven rule-based engine was developed to determine KDIGO staging compared to KD-related keywords in discharge letters. (2) Methods: To assess potential differences in outcomes, we compare the patient subgroups with exact KDIGO staging to imprecise or missing staging for all-cause mortality, in-hospital mortality, selection bias and costs by applying Kaplan–Meier analysis and the Cox proportional hazards regression model. We analysed 63,105 in-patient cases from 2016 to 2023 at a tertiary hospital with AKI, CKD and acute-on-chronic KD. (3) Results: Imprecise and missing CKD staging were associated with an 85% higher risk of all-cause and in-hospital mortality (CI: 1.7 to 2.0 and 1.66 to 2.03, respectively) compared to exact staging for any given disease status; imprecise or missing AKI staging increased in-hospital mortality risk by 56% and 57% (CI: 1.43 to 1.70 and 1.37 to 1.81, respectively) in patients with AKI. (4) Conclusions: Exact staging is associated with better outcomes in KD management. Our study provides valuable insight into potential quality and outcome improvements and lower costs, considering elderly patients, women and patients with acute-on-chronic KD as the most vulnerable.
Keywords: data-driven diagnosis; electronic health records; digital markers; rule engine; precision medicine; real-world data; kidney disease; KDIGO staging data-driven diagnosis; electronic health records; digital markers; rule engine; precision medicine; real-world data; kidney disease; KDIGO staging

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MDPI and ACS Style

Endrich, O.; Nakas, C.T.; Triep, K.; Fiedler, G.M.; Caro, J.J.; McGuire, A. Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study. Diagnostics 2024, 14, 2476. https://doi.org/10.3390/diagnostics14222476

AMA Style

Endrich O, Nakas CT, Triep K, Fiedler GM, Caro JJ, McGuire A. Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study. Diagnostics. 2024; 14(22):2476. https://doi.org/10.3390/diagnostics14222476

Chicago/Turabian Style

Endrich, Olga, Christos T. Nakas, Karen Triep, Georg M. Fiedler, Jaime J. Caro, and Alistair McGuire. 2024. "Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study" Diagnostics 14, no. 22: 2476. https://doi.org/10.3390/diagnostics14222476

APA Style

Endrich, O., Nakas, C. T., Triep, K., Fiedler, G. M., Caro, J. J., & McGuire, A. (2024). Impact of Precision in Staging Acute Kidney Injury and Chronic Kidney Disease on Treatment Outcomes: An Observational Study. Diagnostics, 14(22), 2476. https://doi.org/10.3390/diagnostics14222476

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