CDC Surveillance System: Percentage of Patients with an ICD-9-CM or ICD-10-CM Code Indicating CKD

Prevalence and Incidence

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Prevalence of CKD in the General Population

Prevalence of CKD in the Health Care System Population

Incidence of CKD in the Health Care System Population

Prevalence of CKD Towards Tracking Healthy People 2030 Goals

Awareness

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Person Awareness of CKD

Provider Awareness of CKD

CKD with ICD-9-CM Codes Among U.S. Veterans with CKD Stages 3-5

CKD Awareness Towards Tracking HP2020 Goals

Increase the Proportion of Adults with Chronic Kidney Disease Who Know They Have It

Burden of Risk Factors

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Diabetes in the General Population

Diabetes in the Health Care System Population

U.S. Adults with a Diagnosis of Diabetes

Hypertension in the General Population

Hypertension in the Health Care System Population

U.S. Adults with a Diagnosis of Hypertension

Obesity in the General Population

CVD in the General Population

Smoking in the General Population

Age in the Health Care System Population

Age of U.S. Adults

Race/Ethnicity in the Health Care System Population

U.S. Adults by Race/Ethnicity

Food Insecurity in CKD

Health Consequences

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Mortality in CKD in the Health Care System Population

Mortality Rates by eGFR Category/stage

Physical and Mental Functioning in CKD

Risk Factors for Progression of CKD

Progression

One-year Progression of CKD in U.S. Veterans

Risk Factors for CKD Complications Towards Tracking HP2020 Goals

Quality of Care

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Laboratory Testing for CKD in the Health Care System

Nephrology Care Prior to ESRD

Use of Medications in CKD

Blood Pressure Treatment and Control in CKD

Trends in Hypertension Diagnosis, Treatment, and Control Among Us Veterans

Health Care System Capacity

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Indicator Details: Percentage of Patients with an ICD-9-CM or ICD-10-CM Code Indicating CKD

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Percentage of Patients with an ICD-9-CM or ICD-10-CM Code Indicating CKD by Year and Age Department of Defense Military Health System
Age	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015
18–29 years	.97	1.06	1.09	1.19	1.25	1.08	1.09	1.03	1.01	.95
30–39 years	1.21	1.32	1.38	1.49	1.60	1.49	1.48	1.47	1.44	1.39
40–49 years	1.93	2.16	2.30	2.52	2.66	2.54	2.55	2.57	2.56	2.50
50–59 years	3.93	4.37	4.56	4.88	5.02	4.88	4.77	4.75	4.74	4.60
60–69 years	6.20	6.85	7.14	7.45	7.72	7.67	7.76	7.79	7.95	7.76
70+ years	11.64	13.14	14.10	14.85	15.07	15.43	15.71	15.51	15.23	16.08

The overall unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 2.8%–2.9% since 2009.

Stratified by sex, the unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 2.3%–2.4% for males and 3.3%–3.5% for females.

Stratified by race, the unadjusted percentage of US Military Health System (MHS) patients with a CKD code (ICD-9-CM, including end-stage renal disease [ESRD]) has been relatively stable at 1.7%–1.8% for White, 3.0%–3.2% for Black, 1.9%–2.1% for Asian/Pacific Islander, 1.4%–1.6% for Native American/Alaskan Native, 1.4%–2.0% for Other race, 6.7%–6.8% for Unknown race, and 3.7%–4.0% for Missing race.

Chart Explanation:

These charts show the crude prevalence of CKD diagnosed by ICD-9-CM codes in the MHS by year of observation and CKD risk factor (age, sex, or race) status.

De-identified patient data were obtained from the MHS Data Repository (MDR).

CKD diagnosis was based on encounters with one or more of the matching ICD-9 codes. The full list of codes is provided in Field/Data. CKD diagnosis included ESRD, which was defined as having an ICD-9-M or Current Procedural Terminology (CPT) code for ESRD, chronic hemodialysis, chronic peritoneal dialysis, or kidney transplant.

For the calculation of CKD prevalence, the numerator was the number of patients with at least one inpatient or two outpatient CKD codes. The denominator was the number of patients with at least one inpatient or two outpatient encounters. Data cells with less than 11 patients were censored.

The views expressed are those of the authors and do not reflect the official policy of the Uniformed Services University, Departments of Army/Navy/Air Force, Department of Defense, Centers for Disease Control and Prevention, Department of Health and Human Services, or the US Government.

Field	Data
Description of Measure	Percentage of Patients with an ICD-9-CM Code Indicating CKD or ESRD
Data Source	US Department of Defense Military Health System (MHS) Data Repository (MDR)
Type of Data Source	Administrative
Data Set	MDR source files: CAPER (direct care outpatient claims), SIDR (direct care inpatient claims), TED-NI (purchased care outpatient claims), TED-I Header (purchased care inpatient claims), and VM6BEN (demographic information from the Defense Enrollment Eligibility Reporting System)
Health Care System Data	Yes
Regional or National?	National
Demographic Group	Patients in MHS
Numerator	Patients in denominator with 1 inpatient or 2 outpatient encounters with matching ICD-9-CM codes for CKD or ESRD
Denominator	Patients with 1 inpatient or 2 outpatient encounters during the fiscal year
Definition of diagnosed CKD	See ICD-9-CM codes used for definition below
Primary Data Source Indicator	Diagnosis codes from outpatient or inpatient encounters
Primary Indicator Method of Measurement	Medical claims
Frequency of Measurement (Primary)	Multiple measurements per patient
Period Currently Available	2006–2015
Limitations of Indicator	ICD-9 codes define CKD instead of serum creatinine
Analytical Considerations	In published literature, CKD is diagnosed by ICD-9-CM codes in alternate ways (one outpatient, two or more outpatient, or one inpatient). In addition, there are differences in sampling methods. Care must be taken in making comparisons. These statistics include ESRD patients and use the one inpatient, two outpatient method of identifying CKD.
ICD-9 Codes for CKD	Specification
16	Tuberculosis of kidney
95.4	Syphilis of kidney
189	Malignant neoplasm of kidney except pelvis
189.1	Malignant neoplasm of renal pelvis
189.9	Malignant neoplasm of urinary organ site unspecified
236.91	Neoplasm of uncertain behavior of kidney and ureter
250.4	Diabetes mellitus with renal manifestations type II or unspecified type not stated as uncontrolled
250.41	Diabetes mellitus with renal manifestations type I not stated as
250.42	Diabetes mellitus with renal manifestations type II or unspecified type uncontrolled
250.43	Diabetes mellitus with renal manifestations type I uncontrolled
271.4	Renal glycosuria
274.1	Gouty nephropathy
283.11	Hemolytic-uremic syndrome
403	Malignant hypertensive renal disease without renal failure
403.01	Malignant hypertensive renal disease with renal failure
403.1	Benign hypertensive renal disease without renal failure
403.11	Benign hypertensive renal disease with renal failure
403.9	Unspecified hypertensive renal disease without renal failure
403.91	Unspecified hypertensive renal disease with renal failure
404	Malignant hypertensive heart and renal disease without heart failure or renal failure
404.01	Malignant hypertensive heart and renal disease with heart failure
404.02	Malignant hypertensive heart and renal disease with renal failure
404.03	Malignant hypertensive heart and renal disease with heart failure and renal failure
404.1	Benign hypertensive heart and renal disease without heart failure or renal failure
404.11	Benign hypertensive heart and renal disease with heart failure
404.12	Benign hypertensive heart and renal disease with renal failure
404.13	Benign hypertensive heart and renal disease with heart failure and renal failure
404.9	Unspecified hypertensive heart and renal disease without heart failure or renal failure
404.91	Unspecified hypertensive heart and renal disease with heart failure
404.92	Unspecified hypertensive heart and renal disease with renal failure
404.93	Unspecified hypertensive heart and renal disease with heart failure and renal failure
405.01	Malignant renovascular hypertension
440.1	Atherosclerosis of renal artery
442.1	Aneurysm of renal artery
447.3	Hyperplasia of renal artery
453.3	Embolism and thrombosis of renal vein
572.4	Hepatorenal syndrome
580	Acute glomerulonephritis with lesion of proliferative glomerulonephritis
580.4	Acute glomerulonephritis with lesion of rapidly progressive; glomerulonephritis
580.81	Acute glomerulonephritis in diseases classified elsewhere
580.89	Acute glomerulonephritis with other specified pathological lesion in kidney
580.9	Acute glomerulonephritis with unspecified pathological lesion in kidney
581	Nephrotic syndrome with lesion of proliferative glomerulonephritis
581.1	Nephrotic syndrome with lesion of membranous glomerulonephritis
581.2	Nephrotic syndrome with lesion of membranoproliferative glomerulonephritis
581.3	Nephrotic syndrome with lesion of minimal change glomerulonephritis
581.81	Nephrotic syndrome in diseases classified elsewhere
581.89	Other nephrotic syndrome with specified pathological lesion in kidney
581.9	Nephrotic syndrome with unspecified pathological lesion in kidney
582	Chronic glomerulonephritis with lesion of proliferative glomerulonephritis
582.1	Chronic glomerulonephritis with lesion of membranous glomerulonephritis
582.2	Chronic glomerulonephritis with lesion of membranoproliferative glomerulonephritis
582.4	Chronic glomerulonephritis with lesion of rapidly progressive glomerulonephritis
582.81	Chronic glomerulonephritis in diseases classified elsewhere
582.89	Other chronic glomerulonephritis with specified pathological lesion in kidney
582.9	Chronic glomerulonephritis with unspecified pathological lesion in kidney
583	Nephritis and nephropathy not specified as acute or chronic with lesion of proliferative glomerulonephritis
583.1	Nephritis and nephropathy not specified as acute or chronic with lesion of membranous glomerulonephritis
583.2	Nephritis and nephropathy not specified as acute or chronic with lesion of membranoproliferative glomerulonephritis
583.4	Nephritis and nephropathy not specified as acute or chronic with lesion of rapidly progressive glomerulonephritis
583.6	Nephritis and nephropathy not specified as acute or chronic with lesion of renal cortical necrosis
583.7	Nephritis and nephropathy not specified as acute or chronic with lesion of renal medullary necrosis
583.81	Nephritis and nephropathy not specified as acute or chronic in diseases classified elsewhere
583.89	Other nephritis and nephropathy not specified as acute or chronic with specified pathological lesion in kidney
583.9	Nephritis and nephropathy not specified as acute or chronic with unspecified pathological lesion in kidney
584.5	Acute renal failure with lesion of tubular necrosis
584.6	Acute renal failure with lesion of renal cortical necrosis
584.7	Acute renal failure with lesion of renal medullary (papillary) necrosis
584.8	Acute renal failure with other specified pathological lesion in kidney
584.9	Acute renal failure unspecified
585.x	Chronic renal failure
586	Renal failure unspecified
587	Renal sclerosis unspecified
588	Renal osteodystrophy
588.1	Nephrogenic diabetes insipidus
588.81	Secondary hyperparathyroidism (of renal origin)
588.89	Other specified disorders resulting from impaired renal function
588.9	Unspecified disorder resulting from impaired renal function
589	Small kidney of unknown cause
590	Chronic pyelonephritis
590.8	Other pyelonephritis or pyonephrosis not specified as acute or chronic
591	Hydronephrosis
593.1	Hypertrophy of kidney
593.3	Stricture or kinking of ureter
593.4	Other ureteric obstruction
593.5	Hydroureter
593.6	Postural proteinuria
593.7	Vesicoureteral reflux
593.81	Pyelitis or pyelonephritis in diseases classified elsewhere
593.89	Other specified disorders of kidney and ureter
593.9	Unspecified disorder of kidney and ureter
642.1	Hypertension secondary to renal disease complicating pregnancy childbirth and the puerperium
646.2	Unspecified renal disease in pregnancy without mention of hypertension
753	Renal agenesis and dysgenesis
753.1	Cystic kidney disease unspecified
753.11	Congenital single renal cyst
753.12	Polycystic kidney unspecified type
753.13	Polycystic kidney autosomal dominant
753.14	Polycystic kidney autosomal recessive
753.15	Renal dysplasia
753.16	Medullary cystic kidney
753.17,	Medullary sponge kidney
753.19	Other specified cystic kidney disease
753.2	Unspecified obstructive defect of renal pelvis and ureter
753.21	Congenital obstruction of ureteropelvic junction
753.22	Congenital obstruction of ureterovesical junction
753.23	Congenital ureterocele
753.29	Other obstructive defect of renal pelvis and ureter
753.3	Other specified anomalies of kidney
753.4	Other specified anomalies of ureter
753.5	Exstrophy of urinary bladder
753.6	Atresia and stenosis of urethra and bladder neck
753.7	Anomalies of urachus
753.8	Other specified anomalies of bladder and urethra
753.9	Unspecified anomaly of urinary system
791	Proteinuria
791.1	Chyluria
791.2	Hemoglobinuria
791.3	Myoglobinuria
791.4	Biliuria
791.5	Glycosuria
791.6	Acetonuria
791.7	Other cells and casts in urine
791.9	Other nonspecific findings on examination of urine
794.4	Nonspecific abnormal results of function study of kidney
585.6	End stage renal disease
996.81	Complications of kidney transplant
V42.0	Kidney transplant status
V45.1	Renal dialysis status
V56.0	Renal dialysis encounter
V56.1	Fitting/adjustment extracorporeal dialysis catheter
V56.2	Fitting/adjustment peritoneal dialysis catheter
V56.3	Encounter for adequacy testing for dialysis
V56.31	Hemodialysis testing
V56.32	Peritoneal dialysis test
V56.8	Dialysis encounter, not elsewhere classified
E879.1	Abnormal reaction-renal dialysis

Suggested Citation:

Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd