Phenotype Phebruary Day 29 - Acute Kidney Injury

[Gowtham_Rao]

@Marcela

Even though February ended, we don’t see a good reason to stop this great exercise of building phenotypes and the discussions with the community.

And thank you @Marcela and @david_vizcaya for saying that - there is no reason to stop the momentum! On behalf of everyone I wanted to congratulate on your remarkable journey this past month - for taking this challenge head on, learning the best practice and the OHDSI tools! Thank you for your leadership and your persistence.

I wanted to highlight what I found insightful reading your clinical description!

• this is an acute change to a persons state

@Marcela

abrupt decrease in kidney function

@Marcela

deterioration of renal function must be sudden (1–7 days) and sustained (persisting >24 h)

• persons are usually previously sick, and that could include prior kidney disease

@Marcela

can happen in apparently healthy adults, normally happens as a complication of another serious illness

• there is a diagnostic criteria that is based on measurement values

@Marcela

AKI is defined as any of the following (Not Graded):

1. Increase in SCr by ≥0.3 mg/dl (≥26.5 µmol/l) within 48 hours; or

You have described what is NOT AKI

@Marcela

Patients with end-stage kidney disease (ESKD) are not at risk of AKI

@Marcela

except for chronic hemodialysis as a proxy of ESKD .

You have differentiated between similar diseases - that may be part of spectrum - and clarified that you are interested in AKI

@Marcela

AKD, acute kidney diseases and disorders; AKI, acute kidney injury; CKD, chronic kidney disease;

You have described what constitutes end

@Marcela

This event will continue for 7 days at most.

All events occurring within 7 days will be considered part of this event.

You have highlighted some key points based on literature review:

@Marcela

Several studies have recommended NOT to use diagnoses codes to identify patients with AKI based on the poor sensitivity. As low as 30% sensitivity has been reported for using ICD-10 codes in an inpatient setting (Jannot, 2017). Thus, ideally the phenotype should include lab values.

This clinical description was very useful to me to get a mental model of the type of people we are trying to identify in our datasources.