A simple algorithm to predict incident kidney disease

Abhijit V. Kshirsagar, Heejung Bang, Andrew S. Bomback, Suma Vupputuri, David A. Shoham, Lisa M. Kern, Philip J. Klemmer, Madhu Mazumdar, Phyllis A. August

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Background: Despite the growing burden of chronic kidney disease (CKD), there are no algorithms (to our knowledge) to quantify the effect of concurrent risk factors on the development of incident disease. Methods: A combined cohort (N=14 155) of 2 community-based studies, the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study, was formed among men and women 45 years or older with an estimated glomerular filtration rate (GFR) exceeding 60 mL/min/1.73 m2 at baseline. The primary outcome was the development of a GFR less than 60 mL/min/1.73 m2 during a follow-up period of up to 9 years. Three prediction algorithms derived from the development data set were evaluated in the validation data set. Results: The 3 prediction algorithms were continuous and categorical best-fitting models with 10 predictors and a simplified categorical model with 8 predictors. All showed discrimination with area under the receiver operating characteristic curve in a range of 0.69 to 0.70. In the simplified model, age, anemia, female sex, hypertension, diabetes mellitus, peripheral vascular disease, and history of congestive heart failure or cardiovascular disease were associated with the development of a GFR less than 60 mL/min/1.73 m2. A numeric score of at least 3 using the simplified algorithm captured approximately 70% of incident cases (sensitivity) and accurately predicted a 17% risk of developing CKD (positive predictive value). Conclusions: An algorithm containing commonly understood variables helps to stratify middle-aged and older individuals at high risk for future CKD. The model can be used to guide population-level prevention efforts and to initiate discussions between practitioners and patients about risk for kidney disease.

Original languageEnglish (US)
Pages (from-to)2466-2473
Number of pages8
JournalArchives of Internal Medicine
Volume168
Issue number22
DOIs
StatePublished - Dec 22 2008
Externally publishedYes

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Kidney Diseases
Glomerular Filtration Rate
Chronic Renal Insufficiency
Peripheral Vascular Diseases
ROC Curve
Anemia
Heart Diseases
Atherosclerosis
Diabetes Mellitus
Cardiovascular Diseases
Heart Failure
Hypertension
Health
Population
Datasets

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Kshirsagar, A. V., Bang, H., Bomback, A. S., Vupputuri, S., Shoham, D. A., Kern, L. M., ... August, P. A. (2008). A simple algorithm to predict incident kidney disease. Archives of Internal Medicine, 168(22), 2466-2473. https://doi.org/10.1001/archinte.168.22.2466

A simple algorithm to predict incident kidney disease. / Kshirsagar, Abhijit V.; Bang, Heejung; Bomback, Andrew S.; Vupputuri, Suma; Shoham, David A.; Kern, Lisa M.; Klemmer, Philip J.; Mazumdar, Madhu; August, Phyllis A.

In: Archives of Internal Medicine, Vol. 168, No. 22, 22.12.2008, p. 2466-2473.

Research output: Contribution to journalArticle

Kshirsagar, AV, Bang, H, Bomback, AS, Vupputuri, S, Shoham, DA, Kern, LM, Klemmer, PJ, Mazumdar, M & August, PA 2008, 'A simple algorithm to predict incident kidney disease', Archives of Internal Medicine, vol. 168, no. 22, pp. 2466-2473. https://doi.org/10.1001/archinte.168.22.2466
Kshirsagar AV, Bang H, Bomback AS, Vupputuri S, Shoham DA, Kern LM et al. A simple algorithm to predict incident kidney disease. Archives of Internal Medicine. 2008 Dec 22;168(22):2466-2473. https://doi.org/10.1001/archinte.168.22.2466
Kshirsagar, Abhijit V. ; Bang, Heejung ; Bomback, Andrew S. ; Vupputuri, Suma ; Shoham, David A. ; Kern, Lisa M. ; Klemmer, Philip J. ; Mazumdar, Madhu ; August, Phyllis A. / A simple algorithm to predict incident kidney disease. In: Archives of Internal Medicine. 2008 ; Vol. 168, No. 22. pp. 2466-2473.
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AU - Bomback, Andrew S.

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AU - Shoham, David A.

AU - Kern, Lisa M.

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