Title
Risk score for first-screening of prevalent undiagnosed chronic kidney disease in Peru: The CRONICAS-CKD risk score
Date Issued
29 November 2017
Access level
open access
Resource Type
journal article
Author(s)
Medina-Lezama J.
Muñoz-Retamozo P.V.
Smeeth L.
Casas J.P.
Smith G.D.
Ebrahim S.
Checkley W.
Diette G.B.
Wise R.A.
Publisher(s)
BioMed Central Ltd
Abstract
Background: Chronic Kidney Disease (CKD) represents a great burden for the patient and the health system, particularly if diagnosed at late stages. Consequently, tools to identify patients at high risk of having CKD are needed, particularly in limited-resources settings where laboratory facilities are scarce. This study aimed to develop a risk score for prevalent undiagnosed CKD using data from four settings in Peru: a complete risk score including all associated risk factors and another excluding laboratory-based variables. Methods: Cross-sectional study. We used two population-based studies: one for developing and internal validation (CRONICAS), and another (PREVENCION) for external validation. Risk factors included clinical- and laboratory-based variables, among others: sex, age, hypertension and obesity; and lipid profile, anemia and glucose metabolism. The outcome was undiagnosed CKD: eGFR < 60 ml/min/1.73m2. We tested the performance of the risk scores using the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive/negative predictive values and positive/negative likelihood ratios. Results: Participants in both studies averaged 57.7 years old, and over 50% were females. Age, hypertension and anemia were strongly associated with undiagnosed CKD. In the external validation, at a cut-off point of 2, the complete and laboratory-free risk scores performed similarly well with a ROC area of 76.2% and 76.0%, respectively (P = 0.784). The best assessment parameter of these risk scores was their negative predictive value: 99.1% and 99.0% for the complete and laboratory-free, respectively. Conclusions: The developed risk scores showed a moderate performance as a screening test. People with a score of ≥ 2 points should undergo further testing to rule out CKD. Using the laboratory-free risk score is a practical approach in developing countries where laboratories are not readily available and undiagnosed CKD has significant morbidity and mortality.
Volume
18
Issue
1
Language
English
OCDE Knowledge area
Urología, Nefrología
Subjects
Scopus EID
2-s2.0-85036564975
PubMed ID
Source
BMC Nephrology
ISSN of the container
14712369
Sponsor(s)
National Heart, Lung, and Blood Institute R00HL096955 NHLBI
Sources of information:
Directorio de Producción Científica
Scopus