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Comparison of Patients with Hospital-recorded Nephrotic Syndrome and Patients with Nephrotic Proteinuria and Hypoalbuminemia: a Nationwide Study in Denmark

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Only a minority of patients with the biochemical features of NS receive hospital diagnoses specific to NS.Patients identified with hospital-recorded NS are considerably different from those with biochemical features of NS.Laboratory databases should complement hospital databases to fully elucidate the burden of NS and the prognosis of NS patients.Background: Registry-based studies of nephrotic syndrome (NS) may only include a subset of patients with biochemical features of NS. To address this, we compared patients with laboratory-recorded nephrotic proteinuria and hypoalbuminemia to patients with hospital-recorded NS. Methods: We identified adult patients with first-time hospital-recorded NS (inpatients, outpatients or emergency room visitors) in the Danish National Patient Registry and compared them to adults with first-time recorded nephrotic proteinuria and hypoalbuminemia in Danish laboratory databases during 2004-2018, defining date of admission or laboratory findings as index date. We characterised these cohorts by demographics, comorbidity, medication use, and laboratory and histopathological findings. Results: We identified 1,139 patients with hospital-recorded NS and 5,268 patients with nephrotic proteinuria and hypoalbuminemia of which 760 patients were identified with both. Within one year of the first recorded nephrotic proteinuria and hypoalbuminemia, 18 while 87 most recent eGFR was substantially lower (median of 35 vs. 61 ml/min/1.73 m2), fewer underwent kidney biopsies around index date (341, and prevalence of thromboembolic disease (257 and diabetes (398 was higher when compared to patients with hospital-recorded NS. Conclusions: Patients with nephrotic proteinuria and hypoalbuminemia are five-fold more common than patients with hospital-recorded NS, and they reveal a lower eGFR and more comorbidity. Selective and incomplete recording of NS may be an important issue when designing and interpreting studies of risks and prognosis of NS.
Original languageUndefined/Unknown
Publication statusE-pub ahead of print - Jun 2021

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