The Kidney Disease Risk Equation accurately predicts the onset of CKD within 5 years
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A new risk equation called The Kidney Disease Risk Equation uses six variables to predict the onset of chronic kidney disease within 5 years, and it can be added into existing health care systems, according to a speaker at ASN Kidney Week.
“Our research goal was to develop and validate a prediction tool to predict eGFR less than 60 mL/min[/1.73 m2] using existing administrative or routinely collected data,” Manish M. Sood, MD, MDc, FRCPC, of the Ottawa Hospital Research Institute at The Ottawa Hospital, University of Ottawa, said.
As individuals at risk for CKD are not guaranteed albumin-to-creatinine ratio (ACR) measurements, researchers created an equation that can function with and without ACR.
Sood and colleagues evaluated a cohort of 1,109,905 adults aged older than 66 years from Ontario, Canada, between April 1, 2008, and Dec. 31, 2017. All participants had at least two eGFRs, one greater than 70 mL/min/1.73 m2 to determine their baseline and the other to determine outcome.
The models were stratified by those with an ACR (n=191,690) and those without an ACR (n=998,825) so that the researchers could predict CKD in individuals without an ACR measurement.
“We used spline functions for all our continuous variables,” Sood said. “We included a large number of predictors in our initial model, greater than 47 were included based on previous associations with known early CKD.”
Following the analysis, an eGFR less than 60 mL/min/1.73 m2 occurred in 37.2% of the participants (54.5% were women; mean age, 64 years; mean baseline eGFR, 82 mL/min/1.73 m2; median ACR, 1) during the 9-year follow-up period. Of the original 47 variables, six were included in the final model (age, sex, baseline eGFR, hemoglobin, time from hypertension and diabetes mellitus diagnosis), which produced 5-year c-statistics of 0.77 (no ACR) and 0.78 (with ACR) with “excellent” calibration. The equation was highly accurate in predicting the onset of CKD within 5 years.
Additional analyses performed in Manitoba, Canada, externally validated the model. “In summation, we feel we’ve successfully developed a CKD prediction model that is race-independent and that can either include or exclude a baseline ACR,” Sood said. “The Kidney Disease Risk Equation (KDRE) can be rapidly integrated into existing health care systems and does not require information on an individual's albuminuria or race,” he added in an ASN press release.
References:
Equation predicts chronic kidney disease risk based on readily available information. https://www.newswise.com/articles/equation-predicts-chronic-kidney-disease-risk-based-on-readily-available-information?sc=mwhr&xy=10007438. Published Nov. 3, 2021. Accessed Nov. 12, 2021.
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Sood MM, et al. A prediction equation for incident CKD using routinely collected data: The Kidney Disease Risk Equation (KDRE). Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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