scholarly journals External validation of six clinical models for prediction of unknown chronic kidney disease in a German population

2021 ◽  
Author(s):  
Susanne Stolpe ◽  
Bernd Kowall ◽  
Denise Zwanziger ◽  
Mirjam Frank ◽  
Karl-Heinz Joeckel ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Prediction Models ◽  
Screening Methods ◽  
German Population ◽  
Risk Models ◽  
Validation Data ◽  
Predictive Values ◽  
Diagnostic Properties

Background Chronic kidney disease (CKD) is responsible for large personal health and societal burdens. Screening populations at higher risk for CKD is effective to initiate earlier treatment and decelerate disease progress. We externally validated clinical prediction models for unknown CKD that might be used in population screening. Methods We validated six risk models for prediction of unknown CKD using only non-invasive parameters. Validation data came from 4,185 participants of the German Heinz-Nixdorf-Recall study (HNR), drawn in 2000 from a general population aged 45-75 years. We estimated discrimination and calibration using the full model information, and calculated the diagnostic properties applying the published scoring algorithms of the models using various thresholds for the sum of scores. Results The risk models used four to nine parameters. Age and hypertension were included in all models. Five out of six c-values ranged from 0.71 to 0.73, indicating fair discrimination. Positive predictive values ranged from 15% to 19%, negative predictive values were >93% using score thresholds that resulted in values for sensitivity and specificity above 60%. Conclusions Most of the selected CKD prediction models show fair discrimination in a German general population. The estimated diagnostic properties indicate that the models are suitable for identifying persons at higher risk for unknown CKD without invasive procedures.

scholarly journals Performance of prediction models for nephropathy in people with type 2 diabetes: systematic review and external validation study

BMJ ◽  
2021 ◽  
pp. n2134
Author(s):  
Roderick C Slieker ◽  
Amber A W A van der Heijden ◽  
Moneeza K Siddiqui ◽  
Marlous Langendoen-Gort ◽  
Giel Nijpels ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Diabetic Kidney Disease ◽  
Prediction Models ◽  
External Validation ◽  
Diabetic Kidney

Abstract Objectives To identify and assess the quality and accuracy of prognostic models for nephropathy and to validate these models in external cohorts of people with type 2 diabetes. Design Systematic review and external validation. Data sources PubMed and Embase. Eligibility criteria Studies describing the development of a model to predict the risk of nephropathy, applicable to people with type 2 diabetes. Methods Screening, data extraction, and risk of bias assessment were done in duplicate. Eligible models were externally validated in the Hoorn Diabetes Care System (DCS) cohort (n=11 450) for the same outcomes for which they were developed. Risks of nephropathy were calculated and compared with observed risk over 2, 5, and 10 years of follow-up. Model performance was assessed based on intercept adjusted calibration and discrimination (Harrell’s C statistic). Results 41 studies included in the systematic review reported 64 models, 46 of which were developed in a population with diabetes and 18 in the general population including diabetes as a predictor. The predicted outcomes included albuminuria, diabetic kidney disease, chronic kidney disease (general population), and end stage renal disease. The reported apparent discrimination of the 46 models varied considerably across the different predicted outcomes, from 0.60 (95% confidence interval 0.56 to 0.64) to 0.99 (not available) for the models developed in a diabetes population and from 0.59 (not available) to 0.96 (0.95 to 0.97) for the models developed in the general population. Calibration was reported in 31 of the 41 studies, and the models were generally well calibrated. 21 of the 64 retrieved models were externally validated in the Hoorn DCS cohort for predicting risk of albuminuria, diabetic kidney disease, and chronic kidney disease, with considerable variation in performance across prediction horizons and models. For all three outcomes, however, at least two models had C statistics >0.8, indicating excellent discrimination. In a secondary external validation in GoDARTS (Genetics of Diabetes Audit and Research in Tayside Scotland), models developed for diabetic kidney disease outperformed those for chronic kidney disease. Models were generally well calibrated across all three prediction horizons. Conclusions This study identified multiple prediction models to predict albuminuria, diabetic kidney disease, chronic kidney disease, and end stage renal disease. In the external validation, discrimination and calibration for albuminuria, diabetic kidney disease, and chronic kidney disease varied considerably across prediction horizons and models. For each outcome, however, specific models showed good discrimination and calibration across the three prediction horizons, with clinically accessible predictors, making them applicable in a clinical setting. Systematic review registration PROSPERO CRD42020192831.

scholarly journals Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 282
Author(s):  
Hui-Ju Tsai ◽  
Chih-Hsing Hung ◽  
Chih-Wen Wang ◽  
Hung-Pin Tu ◽  
Chiu-Hui Li ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Estimated Glomerular Filtration Rate ◽  
Synergistic Effects ◽  
Blood Lead ◽  
Southern Taiwan ◽  
The Mean ◽  
Traditional Risk Factors

Background: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. Methods: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Results: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. Conclusion: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.

scholarly journals Environmental Heavy Metal Exposure and Chronic Kidney Disease in the General Population

2015 ◽  
Vol 30 (3) ◽  
pp. 272 ◽  
Author(s):  
Nam Hee Kim ◽  
Young Youl Hyun ◽  
Kyu-Beck Lee ◽  
Yoosoo Chang ◽  
Seungho Rhu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Heavy Metal ◽  
Kidney Disease ◽  
General Population ◽  
Metal Exposure ◽  
Heavy Metal Exposure

The H.U.G.E. formula (hematocrit, urea, sex) for screening chronic kidney disease (CKD) in an age-stratified general population

2015 ◽  
Vol 19 (6) ◽  
pp. 688-692 ◽  
Author(s):  
Nicolás Roberto Robles Perez-Monteoliva ◽  
F. J. Felix ◽  
L. Lozano ◽  
I. Miranda ◽  
D. Fernandez-Berges ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population

HIV-associated kidney disease in the context of an aging population

Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 485 ◽  
Author(s):  
Claire Naftalin ◽  
Bavithra Nathan ◽  
Lisa Hamzah ◽  
Frank A. Post
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Kidney Disease ◽  
General Population ◽  
Life Expectancy ◽  
Hiv Care ◽  
Developed World

Acute renal failure and chronic kidney disease are more common in HIV-infected patients compared with the general population. Several studies have shown age to be a risk factor for HIV-associated kidney disease. The improved life expectancy of HIV-infected patients as a result of widespread use of antiretroviral therapy has resulted in progressive aging of HIV cohorts in the developed world, and an increased burden of cardiovascular and kidney disease. Consequently, HIV care increasingly needs to incorporate strategies to detect and manage these non-infectious co-morbidities.

Abstract P255: Association of Mild Chronic Kidney Disease with Venous Thromboembolism: Pooled Analysis of Prospective General Population Cohorts

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bakhtawar K Mahmoodi ◽  
Ron T Gansevoort ◽  
Inger Anne Naess ◽  
Pamela L Lutsey ◽  
Sigrid K Braekkan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Venous Thromboembolism ◽  
Kidney Disease ◽  
General Population ◽  
Cox Regression ◽  
Meta Analysis ◽  
Random Effect ◽  
Pooled Analysis ◽  
Individual Level ◽  
Increased Risk

Background: Recent findings suggest that mild chronic kidney disease (CKD) might be associated with increased risk of venous thromboembolism (VTE). However, results were partially inconsistent, which may be due to lack of power. We therefore performed a meta-analysis to investigate the association between mild CKD and VTE incidence. Methods: A literature search was performed to retrieve community-based cohorts with information on the association of estimated glomerular filtration rate (eGFR) and albuminuria with VTE. Five cohorts were identified that were pooled on individual level. To obtain pooled hazard ratios (HRs) for VTE, linear spline models were fitted using Cox regression with shared-frailty. Models were adjusted for age, sex, hypertension, total cholesterol, smoking, diabetes, history of cardiovascular disease and body-mass index. Random-effect meta-analysis was used to obtain adjusted pooled HRs of VTE with CKD versus no CKD. Results: The analysis included 95,154 participants with 1,178 VTE cases and 599,453 person-years of follow-up. Risk of VTE increased continuously with lower eGFR and higher ACR (Figure). Compared with eGFR 100 mL/min/1.73m², pooled adjusted HRs for VTE were 1.3 (1.0–1.7) for eGFR 60, 1.8 (1.3–2.6) for 45 and 1.9 (1.2–2.9) for 30 mL/min/1.73m². Compared with albumin-creatinine ratio (ACR) 5 mg/g, pooled adjusted HRs for VTE were 1.3 (1.04–1.7) for ACR 30, 1.6 (1.1–2.4) for 300 and 1.9 (1.2–3.1) for 1000 mg/g. There was no evidence for interaction between eGFR and ACR (P=0.22). The pooled adjusted HR for CKD (eGFR <60 ml/min/1.73m² or albuminuria ≥30 mg/g) vs. no CKD was 1.5 (95%CI, 1.2–2.1). Results were similar for idiopathic and provoked VTE. Conclusion: Both reduced eGFR and elevated albuminuria are novel independent predictors of VTE in the general population.

scholarly journals Chronic kidney disease: Epidemiologic study

2021 ◽  
pp. 12-14
Author(s):  
Sai Sravani Tellabati ◽  
Kavya B ◽  
Angel A ◽  
Rajya Lakshmi Y ◽  
Dr. SD. Abdul Jabbar Basha ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Epidemiologic Study ◽  
Health Expenditures ◽  
Screening And Prevention ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease ( CKD)  is set in 5 stages of increasing severity with a decrease in glomerular filteration rate leading to end stage renal disease( ESRD) requring a treatment of substitution,dialysis or transplantation. CKD is frequent , it increases with age ,and effects one person out of ten in the general population,and only 4 per 1,00,000 will reach end stage renal disesase( ESRD). As soon as it occurs , CKD is associated with increased cardio vacsular comorbid condition.Mortality in dialysis is far higher than in the general population.In France , more than 4billion euros per year, that is 2%of overall health expenditures or dedicated to the treatment of 0.11%of the population.It is therefore at the early stahlges of CKD that the efforts of screening and prevention ofESRD should be targeted.

scholarly journals Urinary Calcium Excretion and Risk of Chronic Kidney Disease in the General Population

2017 ◽  
Vol 2 (3) ◽  
pp. 366-379 ◽  
Author(s):  
Jacob M. Taylor ◽  
Lyanne M. Kieneker ◽  
Martin H. de Borst ◽  
Sipke T. Visser ◽  
Ido P. Kema ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
General Population ◽  
Urinary Calcium ◽  
Urinary Calcium Excretion ◽  
Calcium Excretion
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