Accuracy of Diagnostic Coding for Acute Kidney Injury in Japan—Analysis of a Japanese Hospital‐Based Database

ABSTRACT Purpose To evaluate the accuracy of diagnostic coding for acute kidney injury (AKI) in Japan. Methods The data analyzed were obtained from the JMDC hospital‐based administrative claims database from cases registered between April 2014 and August 2022. Only patients who underwent serum creat...

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Bibliographic Details
Published in:Pharmacoepidemiology and drug safety Vol. 34; no. 4; pp. e70146 - n/a
Main Authors: Mitsuboshi, Satoru, Imai, Shungo, Tsuchiya, Masami, Kizaki, Hayato, Hori, Satoko
Format: Journal Article
Language:English
Published: Chichester, UK John Wiley & Sons, Inc 01.04.2025
Wiley Subscription Services, Inc
Subjects:
acute kidney injury
Acute Kidney Injury - diagnosis
Acute Kidney Injury - epidemiology
Adult
Aged
Aged, 80 and over
Brief Report
Clinical Coding - standards
Clinical Coding - statistics & numerical data
Codes
Creatinine
Creatinine - blood
Databases, Factual - statistics & numerical data
East Asian People
Female
hospital‐based database
Humans
International Classification of Diseases - standards
Japan - epidemiology
Kidney diseases
Kidneys
Male
Middle Aged
positive predictive value
Predictive Value of Tests
serum creatinine
Young Adult
Japan
positive predictive value
acute kidney injury
hospital‐based database
serum creatinine
ISSN:1053-8569, 1099-1557, 1099-1557
Online Access:Get full text
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Summary:ABSTRACT Purpose To evaluate the accuracy of diagnostic coding for acute kidney injury (AKI) in Japan. Methods The data analyzed were obtained from the JMDC hospital‐based administrative claims database from cases registered between April 2014 and August 2022. Only patients who underwent serum creatinine measurements two or more times with intervals of 7 days or less were eligible for inclusion. AKIs were identified by International Classification of Diseases 10th Revision (ICD‐10) codes N14 and N17. These were assessed according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results A total of 467 019 patients (median age, 74 [range, 20–99] years; male, 50.9%) were eligible for inclusion. Among these patients, 1849 (0.4%) were assigned ICD‐10 codes for AKI. Among these 1849 patients, the code was assigned within 7 days of the occurrence of AKI (as defined by the KDIGO criteria) in 212 patients, within 14 days in 294 patients, and within 30 days in 386 patients. The positive predictive values and 95% confidence intervals of the ICD‐10 code for AKI at these timepoints were as follows: within 7 days, 11.5% (10.1%–13.0%); within 14 days, 15.9% (14.3%–17.6%); and within 30 days, 20.9% (19.1%–22.8%). Conclusions The ICD‐10 codes for AKI showed poor positive predictive values for AKI as defined by the KDIGO criteria, suggesting that it may be difficult to identify AKI using ICD‐10 codes alone in the Japanese context.
Bibliography:Funding
This work was supported by the Japan Science and Technology Agency (CREST Grant Number JPMJCR22N1) and JSPS KAKENHI (grant number JP20K16035).
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Funding: This work was supported by the Japan Science and Technology Agency (CREST Grant Number JPMJCR22N1) and JSPS KAKENHI (grant number JP20K16035).
ISSN:1053-8569
1099-1557
1099-1557
DOI:10.1002/pds.70146