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BMC Nephrology

, 18:240

Epidemiology and Health Outcomes

Abstract

BackgroundAsians have among the highest prevalence of chronic kidney disease CKD or end-stage renal disease in the world. A risk score capable of identifying high risk individuals at the primary care level could allow targeted therapy to prevent future development of CKD. Risk scores for new CKD have been developed in US general populations, but the impact of various risks factors for development of CKD may differ in Asian subjects. In this study, we aimed to develop risk models and simplified risk scores to predict the development of decreased glomerular filtration rate GFR at 10 years in an Asian general population using readily obtainable clinical and laboratory parameters.

MethodsEmployees of EGAT The Electric Generating Authority of Thailand were studied prospectively. Multivariable logistic regression models were used to assess risk factors and used to derive risk models and risk scores for developing decreased GFR at 10 years: Model 1 Clinical only, Model 2 Clinical + Limited laboratory tests, and Model 3 Clinical + Full laboratory tests. The performance of the risk models or risk scores to predict incident cases with decreased GFR were evaluated by tests of calibration and discrimination.

ResultsOf 3186 subjects with preserved GFR eGFR ≥60 at baseline, 271 8.5% developed decreased GFR eGFR < 60 at 10 years. Model 1 Age, sex, systolic blood pressure, history of diabetes, and waist circumference had good performance χ = 9.02; AUC = 0.72. Model 2 Age, Sex, systolic blood pressure, diabetes, glomerular filtration rate had better discrimination χ = 10.87, AUC = 0.79 than Model 1. Model 3 Model 2+ Uric acid, Hemoglobin did not provide significant improvement over Model 2. Based on these findings, simplified categorical risk scores were developed for Models 1 and 2.

ConclusionsClinical or combined clinical and laboratory risk models or risk scores using tests readily available in a resource-limited setting had good accuracy and discrimination power to estimate the 10-year probability of developing decreased GFR in a Thai general population. The benefits of the risk scores in identifying high risk individuals in the Thai or other Asian communities for special intervention requires further studies.

KeywordsAsian Cohort Chronic kidney disease EGAT Population Risk score Thai AbbreviationsAUCArea under the curve

CKD-EPIChronic Kidney Disease–Epidemiology Collaboration

DBPDiastolic blood pressure

DMDiabetes mellitus

EGATThe Electric Generating Authority of Thailand

ESRDEnd-Stage renal disease

GFRGlomerular filtration rate

HDLHigh-density lipoprotein

HTNHypertensive

LDLLow-density lipoprotein

MDRDModification of diet in renal disease study.

SBPSystolic blood pressure

Electronic supplementary materialThe online version of this article doi:10.1186-s12882-017-0653-z contains supplementary material, which is available to authorized users.

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Autor: Krittika Saranburut - Prin Vathesatogkit - Nisakron Thongmung - Anchalee Chittamma - Somlak Vanavanan - Tuangrat Tangstheanp

Fuente: https://link.springer.com/







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