SCreening for Occult REnal Disease (SCORED): A simple prediction model for chronic kidney disease

Heejung Bang, Suma Vupputuri, David A. Shoham, Philip J. Klemmer, Ronald J. Falk, Madhu Mazumdar, Debbie Gipson, Romulo E. Colindres, Abhijit V. Kshirsagar

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background: Despite the wide availability and low cost of serum creatinine measurement, at-risk populations are not routinely tested for chronic kidney disease (CKD). Methods: We used a cross-sectional analysis of a nationally representative, population-based survey to develop a system, SCORED (SCreening for Occult REnal Disease), that uses routinely available demographic and medical information to identify individuals with an increased likelihood of CKD. The analysis included 8530 adult participants in the National Health and Nutrition Examination Surveys conducted from 1999 to 2000 and 2001 to 2002 in the United States. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m2. Univariate and multivariate associations between a comprehensive set of risk factors and CKD were examined to develop a prediction model. The optimal characteristics of the model were examined with internal measures. External validation was performed using the Atherosclerosis Risk in Communities study. A model-based numeric scoring system was developed. Results: Age (P<.001), female sex (P=.02), and various health conditions (hypertension [P=.03], diabetes [P=.03], and peripheral vascular disease [P=.008]; history of cardiovascular disease [P=.001] and congestive heart failure [P=.04]; and proteinuria [P<.001] and anemia [P=.003]) were associated with CKD. The multivariate model was well validated in the internal and external data sets (area under the receiver operating characteristic curve of 0.88 and 0.71, respectively). A score of 4 or greater was chosen by internal validation as a cutoff point for screening based on the diagnostic characteristics (sensitivity, 92%; specificity, 68%; positive predictive value, 18%; and negative predictive value, 99%). Conclusion: This scoring system, weighted toward common variables associated with CKD, may be a useful tool to identify individuals with a high likelihood of occult kidney disease.

Original languageEnglish (US)
Pages (from-to)374-381
Number of pages8
JournalArchives of Internal Medicine
Volume167
Issue number4
DOIs
StatePublished - Feb 26 2007
Externally publishedYes

Fingerprint

Chronic Renal Insufficiency
Kidney
Peripheral Vascular Diseases
Nutrition Surveys
Kidney Diseases
Glomerular Filtration Rate
Proteinuria
ROC Curve
Anemia
Creatinine
Atherosclerosis
Cardiovascular Diseases
Heart Failure
Cross-Sectional Studies
Demography
Hypertension
Costs and Cost Analysis
Health
Serum
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Bang, H., Vupputuri, S., Shoham, D. A., Klemmer, P. J., Falk, R. J., Mazumdar, M., ... Kshirsagar, A. V. (2007). SCreening for Occult REnal Disease (SCORED): A simple prediction model for chronic kidney disease. Archives of Internal Medicine, 167(4), 374-381. https://doi.org/10.1001/archinte.167.4.374

SCreening for Occult REnal Disease (SCORED) : A simple prediction model for chronic kidney disease. / Bang, Heejung; Vupputuri, Suma; Shoham, David A.; Klemmer, Philip J.; Falk, Ronald J.; Mazumdar, Madhu; Gipson, Debbie; Colindres, Romulo E.; Kshirsagar, Abhijit V.

In: Archives of Internal Medicine, Vol. 167, No. 4, 26.02.2007, p. 374-381.

Research output: Contribution to journalArticle

Bang, H, Vupputuri, S, Shoham, DA, Klemmer, PJ, Falk, RJ, Mazumdar, M, Gipson, D, Colindres, RE & Kshirsagar, AV 2007, 'SCreening for Occult REnal Disease (SCORED): A simple prediction model for chronic kidney disease', Archives of Internal Medicine, vol. 167, no. 4, pp. 374-381. https://doi.org/10.1001/archinte.167.4.374
Bang, Heejung ; Vupputuri, Suma ; Shoham, David A. ; Klemmer, Philip J. ; Falk, Ronald J. ; Mazumdar, Madhu ; Gipson, Debbie ; Colindres, Romulo E. ; Kshirsagar, Abhijit V. / SCreening for Occult REnal Disease (SCORED) : A simple prediction model for chronic kidney disease. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 4. pp. 374-381.
@article{147664edbb7b49b9887832f57bd3a067,
title = "SCreening for Occult REnal Disease (SCORED): A simple prediction model for chronic kidney disease",
abstract = "Background: Despite the wide availability and low cost of serum creatinine measurement, at-risk populations are not routinely tested for chronic kidney disease (CKD). Methods: We used a cross-sectional analysis of a nationally representative, population-based survey to develop a system, SCORED (SCreening for Occult REnal Disease), that uses routinely available demographic and medical information to identify individuals with an increased likelihood of CKD. The analysis included 8530 adult participants in the National Health and Nutrition Examination Surveys conducted from 1999 to 2000 and 2001 to 2002 in the United States. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m2. Univariate and multivariate associations between a comprehensive set of risk factors and CKD were examined to develop a prediction model. The optimal characteristics of the model were examined with internal measures. External validation was performed using the Atherosclerosis Risk in Communities study. A model-based numeric scoring system was developed. Results: Age (P<.001), female sex (P=.02), and various health conditions (hypertension [P=.03], diabetes [P=.03], and peripheral vascular disease [P=.008]; history of cardiovascular disease [P=.001] and congestive heart failure [P=.04]; and proteinuria [P<.001] and anemia [P=.003]) were associated with CKD. The multivariate model was well validated in the internal and external data sets (area under the receiver operating characteristic curve of 0.88 and 0.71, respectively). A score of 4 or greater was chosen by internal validation as a cutoff point for screening based on the diagnostic characteristics (sensitivity, 92{\%}; specificity, 68{\%}; positive predictive value, 18{\%}; and negative predictive value, 99{\%}). Conclusion: This scoring system, weighted toward common variables associated with CKD, may be a useful tool to identify individuals with a high likelihood of occult kidney disease.",
author = "Heejung Bang and Suma Vupputuri and Shoham, {David A.} and Klemmer, {Philip J.} and Falk, {Ronald J.} and Madhu Mazumdar and Debbie Gipson and Colindres, {Romulo E.} and Kshirsagar, {Abhijit V.}",
year = "2007",
month = "2",
day = "26",
doi = "10.1001/archinte.167.4.374",
language = "English (US)",
volume = "167",
pages = "374--381",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "4",

}

TY - JOUR

T1 - SCreening for Occult REnal Disease (SCORED)

T2 - A simple prediction model for chronic kidney disease

AU - Bang, Heejung

AU - Vupputuri, Suma

AU - Shoham, David A.

AU - Klemmer, Philip J.

AU - Falk, Ronald J.

AU - Mazumdar, Madhu

AU - Gipson, Debbie

AU - Colindres, Romulo E.

AU - Kshirsagar, Abhijit V.

PY - 2007/2/26

Y1 - 2007/2/26

N2 - Background: Despite the wide availability and low cost of serum creatinine measurement, at-risk populations are not routinely tested for chronic kidney disease (CKD). Methods: We used a cross-sectional analysis of a nationally representative, population-based survey to develop a system, SCORED (SCreening for Occult REnal Disease), that uses routinely available demographic and medical information to identify individuals with an increased likelihood of CKD. The analysis included 8530 adult participants in the National Health and Nutrition Examination Surveys conducted from 1999 to 2000 and 2001 to 2002 in the United States. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m2. Univariate and multivariate associations between a comprehensive set of risk factors and CKD were examined to develop a prediction model. The optimal characteristics of the model were examined with internal measures. External validation was performed using the Atherosclerosis Risk in Communities study. A model-based numeric scoring system was developed. Results: Age (P<.001), female sex (P=.02), and various health conditions (hypertension [P=.03], diabetes [P=.03], and peripheral vascular disease [P=.008]; history of cardiovascular disease [P=.001] and congestive heart failure [P=.04]; and proteinuria [P<.001] and anemia [P=.003]) were associated with CKD. The multivariate model was well validated in the internal and external data sets (area under the receiver operating characteristic curve of 0.88 and 0.71, respectively). A score of 4 or greater was chosen by internal validation as a cutoff point for screening based on the diagnostic characteristics (sensitivity, 92%; specificity, 68%; positive predictive value, 18%; and negative predictive value, 99%). Conclusion: This scoring system, weighted toward common variables associated with CKD, may be a useful tool to identify individuals with a high likelihood of occult kidney disease.

AB - Background: Despite the wide availability and low cost of serum creatinine measurement, at-risk populations are not routinely tested for chronic kidney disease (CKD). Methods: We used a cross-sectional analysis of a nationally representative, population-based survey to develop a system, SCORED (SCreening for Occult REnal Disease), that uses routinely available demographic and medical information to identify individuals with an increased likelihood of CKD. The analysis included 8530 adult participants in the National Health and Nutrition Examination Surveys conducted from 1999 to 2000 and 2001 to 2002 in the United States. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m2. Univariate and multivariate associations between a comprehensive set of risk factors and CKD were examined to develop a prediction model. The optimal characteristics of the model were examined with internal measures. External validation was performed using the Atherosclerosis Risk in Communities study. A model-based numeric scoring system was developed. Results: Age (P<.001), female sex (P=.02), and various health conditions (hypertension [P=.03], diabetes [P=.03], and peripheral vascular disease [P=.008]; history of cardiovascular disease [P=.001] and congestive heart failure [P=.04]; and proteinuria [P<.001] and anemia [P=.003]) were associated with CKD. The multivariate model was well validated in the internal and external data sets (area under the receiver operating characteristic curve of 0.88 and 0.71, respectively). A score of 4 or greater was chosen by internal validation as a cutoff point for screening based on the diagnostic characteristics (sensitivity, 92%; specificity, 68%; positive predictive value, 18%; and negative predictive value, 99%). Conclusion: This scoring system, weighted toward common variables associated with CKD, may be a useful tool to identify individuals with a high likelihood of occult kidney disease.

UR - http://www.scopus.com/inward/record.url?scp=33847415871&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33847415871&partnerID=8YFLogxK

U2 - 10.1001/archinte.167.4.374

DO - 10.1001/archinte.167.4.374

M3 - Article

C2 - 17325299

AN - SCOPUS:33847415871

VL - 167

SP - 374

EP - 381

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 4

ER -