A risk score for chronic kidney disease in the general population.
A risk score for chronic kidney disease in the general population.
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DOI：
10.1016/j.amjmed.2011.09.009
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发表时间：
2012-03
影响因子：
5.9
通讯作者：
Fox, Caroline S.
中科院分区：
文献类型：
--
作者：
O'Seaghdha, Conall M.;Lyass, Asya;Massaro, Joseph M.;Meigs, James B.;Coresh, Josef;D'Agostino, Ralph B., Sr.;Astor, Brad C.;Fox, Caroline S.
对有慢性肾脏病风险的个体进行分层可以优化预防措施，以减少疾病的发生率和并发症。我们试图制定一个风险评分来评估个人发生慢性肾脏疾病的绝对风险。弗雷明汉心脏研究参与者没有基线慢性肾病，他们参加了 1995-1998 年的基线检查和 2005-2008 年的随访，被纳入分析 (n=2,490)。慢性肾病定义为使用肾病饮食修改（MDRD）方程估计的肾小球滤过率<60 ml/min/1.73m2。参与者在 10 年随访时接受了慢性肾脏病发展情况的评估。逐步逻辑回归用于识别慢性肾病危险因素，并用于构建预测 10 年慢性肾病风险的风险评分。使用校准和歧视措施评估绩效特征。最终模型在双种族社区动脉粥样硬化风险 (ARIC) 研究 (n=1,777) 中得到了外部验证。基线时有 1,171 名男性和 1,319 名女性，平均年龄为 57.1 岁。随访时，9.2%（n=229）患有慢性肾病。年龄、糖尿病、高血压、基线估计肾小球滤过率和蛋白尿与慢性肾脏病的发生独立相关（p<0.05），并且这些协变量被纳入风险函数（c 统计量 0.813）。在 ARIC 研究的外部验证中，白人 (n=1,353) 的 c 统计量为 0.79，黑人 (n=424) 的 c 统计量为 0.75。慢性肾病的风险分层可以使用初级保健中容易获得的临床因素得出的风险评分来实现。该评分在识别社区中慢性肾病高风险个体方面的效用值得进一步研究。
Stratification of individuals at risk for chronic kidney disease may allow optimization of preventive measures to reduce disease incidence and complications. We sought to develop a risk score that estimates an individual’s absolute risk of incident chronic kidney disease. Framingham Heart Study participants free of baseline chronic kidney disease, who attended a baseline examination in 1995–1998 and follow-up in 2005–2008, were included in the analysis (n=2,490). Chronic kidney disease was defined as an estimated glomerular filtration rate <60 ml/min/1.73m2 using the Modification of Diet in Renal Disease (MDRD) equation. Participants were assessed for the development of chronic kidney disease at 10 years follow-up. Stepwise logistic regression was used to identify chronic kidney disease risk factors, and these were used to construct a risk score predicting 10-year chronic kidney disease risk. Performance characteristics were assessed using calibration and discrimination measures. The final model was externally validated in the bi-ethnic Atherosclerosis Risk in Communities (ARIC) Study (n=1,777). There were 1,171 men and 1,319 women at baseline, and the mean age was 57.1 years. At follow-up, 9.2% (n=229) had developed chronic kidney disease. Age, diabetes, hypertension, baseline estimated glomerular filtration rate and albuminuria were independently associated with incident chronic kidney disease (p<0.05), and these covariates were incorporated into a risk function (c-statistic 0.813). In external validation in the ARIC study, the c-statistic was 0.79 in whites (n=1,353) and 0.75 in blacks (n=424). Risk stratification for chronic kidney disease is achievable using a risk score derived from clinical factors that are readily accessible in primary care. The utility of this score in identifying individuals in the community at high risk of chronic kidney disease warrants further investigation.
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影响因子：
5.9
作者：
Chien, Kuo-Liong;Lin, Hung-Ju;Chen, Ming-Fong
通讯作者：
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作者：
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通讯作者：
Levey, Andrew S.
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作者：
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通讯作者：
August, Phyllis A.