Oliver JD, Nee R, Grunwald LR, Banaag A, Pavkov ME, Burrows NR, Koehlmoos TP, Marks ES. Prevalence and Characteristics of CKD in the US Military Health System: A Retrospective Cohort Study.
Kidney Med 2022;
4:100487. [PMID:
35812527 PMCID:
PMC9257409 DOI:
10.1016/j.xkme.2022.100487]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Rationale & Objective
The US Military Health System (MHS) is a global health care network with a diverse population that is more representative of the US population than other study cohorts and with fewer disparities in health care access. We aimed to examine the prevalence of chronic kidney disease (CKD) in the MHS and within demographic subpopulations.
Study Design
Multiple cross-sectional analyses of demographic and claims-based data extracted from the MHS Data Repository, 1 for each fiscal year from 2006-2015.
Setting & Population
Multicenter health care network including active-duty military, retirees, and dependents. The average yearly sample size was 3,285,348 individuals.
Exposures
Age, sex, race, active-duty status, and active-duty rank (a surrogate for socioeconomic status).
Outcome
CKD, defined as the presence of matching International Classification of Diseases, Ninth Revision, codes on either 1 or more inpatient or 2 or more outpatient encounters.
Analytical Approach
t test for continuous variables and χ2 test for categorical variables; multivariable logistic regression for odds ratios.
Results
For 2015, the mean (standard deviation) age was 38 (16). Crude CKD prevalence was 2.9%. Age-adjusted prevalence was 4.9% overall—1.9% active-duty and 5.4% non–active-duty individuals. ORs for CKD were calculated with multiple imputations to account for missing data on race. After adjustment, the ORs for CKD (all P < 0.001) were 1.63 (95% CI, 1.62-1.64) for an age greater than 40 years, 1.16 (95% CI, 1.15-1.17) for Black race, 1.15 (95% CI, 1.14-1.16) for senior enlisted rank, 0.94 (95% CI, 0.93-0.95) for women, and 0.50 (95% CI, 0.49-0.51) for active-duty status.
Limitations
Retrospective study based on International Classification of Diseases, Ninth Revision, coding.
Conclusions
Within the MHS, older age, Black race, and senior enlisted rank were associated with a higher risk of CKD, whereas female sex and active-duty status were associated with a lower risk.
Collapse