Clinical Scorecard: Assessing ICD-10-CM Algorithms for Repeated eGFR-Defined Chronic Kidney Disease in the TriNetX Network
At a Glance
Category
Detail
Condition
Clinical topic addressed by the source article: Assessing ICD-10-CM Algorithms for Repeated eGFR-Defined Chronic Kidney Disease in the TriNetX Network
Key Mechanisms
The study compared ICD-10-CM algorithms with repeated eGFR-defined CKD; requiring more codes or restricting code timing increased PPV while decreasing sensitivity.
Target Population
Adults in the TriNetX US Collaborative Network with at least two eGFR measurements obtained from 2021 through 2025.
Care Setting
Care setting described in the source article.
Key Highlights
The cohort included 8,239,691 adults with at least two eGFR measurements; 1,328,952 met laboratory criteria for CKD stage 3 or higher.
For stage 3 or higher, one ICD-10-CM code had 64.1% sensitivity, 95.6% specificity, 73.8% PPV, and 93.3% NPV.
For stage 4 or higher, one code had 79.2% sensitivity, 98.0% specificity, 57.3% PPV, and 99.3% NPV.
Requiring at least two codes or restricting code ascertainment to ±3, ±6, or ±12 months reduced sensitivity and increased PPV.
Temporal restriction raised PPV to approximately 96% for stage 3 or higher and 93% for stage 4 or higher.
Guideline-Based Recommendations
Diagnosis
The study used repeated eGFR measurements as the reference standard for CKD and evaluated ICD-10-CM algorithms against that standard.
Management
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Adults aged 18 years or older in the TriNetX US Collaborative Network with at least two eGFR measurements during 2021–2025; individuals with unknown sex or without a qualifying eGFR 90–365 days before the index measurement were excluded.
No treatments or prescribing patterns were evaluated. The study compared ICD-10-CM coding algorithms with repeated eGFR-defined CKD.
Clinical Best Practices
The authors state that ICD-based phenotype selection should reflect the research application, because code-count and temporal restrictions trade sensitivity for PPV.
The authors suggest that future phenotyping approaches combining diagnosis codes with longitudinal laboratory data may improve identification.
Investigators linked distinct odor patterns to life stage, sex, and skin microbes, while limited longitudinal evidence leaves their clinical utility uncertain.
