Defining measures of kidney function in observational studies using routine healthcare data: methodological and reporting considerations

Juan Jesus Carrero (Lead / Corresponding author), Edouard L. Fu, Søren V. Vestergaard, Simon Kok Jensen, Alessandro Gasparini, Viyaasan Mahalingasivam, Samira Bell, Henrik Birn, Uffe Heide-Jørgensen, Catherine M. Clase, Faye Cleary, Josef Coresh, Friedo W. Dekker, Ron T. Gansevoort, Brenda R. Hemmelgarn, Kitty J. Jager, Tazeen H. Jafar, Csaba P. Kovesdy, Manish M. Sood, Bénédicte StengelChristian F. Christiansen, Masao Iwagami, Dorothea Nitsch (Lead / Corresponding author)

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)
10 Downloads (Pure)


The availability of electronic health records and access to a large number of routine measurements of serum creatinine and urinary albumin enhance the possibilities for epidemiologic research in kidney disease. However, the frequency of health care use and laboratory testing is determined by health status and indication, imposing certain challenges when identifying patients with kidney injury or disease, when using markers of kidney function as covariates, or when evaluating kidney outcomes. Depending on the specific research question, this may influence the interpretation, generalizability, and/or validity of study results. This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using 3 examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected health care data.

Original languageEnglish
Pages (from-to)53-69
Number of pages17
JournalKidney International
Issue number1
Early online date21 Oct 2022
Publication statusPublished - Jan 2023


  • albuminuria
  • chronic kidney disease (CKD)
  • creatinine
  • epidemiology
  • estimated glomerular filtration rate (eGFR)
  • routinely collected health care data


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