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@ARTICLE{Nelson:147513,
author = {R. G. Nelson and M. E. Grams and S. H. Ballew and Y. Sang
and F. Azizi and S. J. Chadban and L. Chaker and S. C.
Dunning and C. Fox and Y. Hirakawa and K. Iseki and J. Ix
and T. H. Jafar and A. Köttgen and D. M. J. Naimark and T.
Ohkubo and G. J. Prescott and C. M. Rebholz and C.
Sabanayagam and T. Sairenchi and B. Schöttker$^*$ and Y.
Shibagaki and M. Tonelli and L. Zhang and R. T. Gansevoort
and K. Matsushita and M. Woodward and J. Coresh and V.
Shalev},
collaboration = {C. P. Consortium},
title = {{D}evelopment of {R}isk {P}rediction {E}quations for
{I}ncident {C}hronic {K}idney {D}isease.},
journal = {The journal of the American Medical Association},
volume = {322},
number = {21},
issn = {0098-7484},
address = {Chicago, Ill.},
publisher = {American Medical Association},
reportid = {DKFZ-2019-02567},
pages = {2104-2114},
year = {2019},
note = {JAMA. 2019;322(21):2104-2114},
abstract = {Early identification of individuals at elevated risk of
developing chronic kidney disease (CKD) could improve
clinical care through enhanced surveillance and better
management of underlying health conditions.To develop
assessment tools to identify individuals at increased risk
of CKD, defined by reduced estimated glomerular filtration
rate (eGFR).Individual-level data analysis of 34
multinational cohorts from the CKD Prognosis Consortium
including 5 222 711 individuals from 28 countries. Data
were collected from April 1970 through January 2017. A
2-stage analysis was performed, with each study first
analyzed individually and summarized overall using a
weighted average. Because clinical variables were often
differentially available by diabetes status, models were
developed separately for participants with diabetes and
without diabetes. Discrimination and calibration were also
tested in 9 external cohorts
(n = 2 253 540).Demographic and clinical
factors.Incident eGFR of less than 60 mL/min/1.73 m2.Among
4 441 084 participants without diabetes (mean age, 54
years, $38\%$ women), 660 856 incident cases $(14.9\%)$ of
reduced eGFR occurred during a mean follow-up of 4.2 years.
Of 781 627 participants with diabetes (mean age, 62 years,
$13\%$ women), 313 646 incident cases $(40\%)$ occurred
during a mean follow-up of 3.9 years. Equations for the
5-year risk of reduced eGFR included age, sex,
race/ethnicity, eGFR, history of cardiovascular disease,
ever smoker, hypertension, body mass index, and albuminuria
concentration. For participants with diabetes, the models
also included diabetes medications, hemoglobin A1c, and the
interaction between the 2. The risk equations had a median C
statistic for the 5-year predicted probability of 0.845
(interquartile range [IQR], 0.789-0.890) in the cohorts
without diabetes and 0.801 (IQR, 0.750-0.819) in the cohorts
with diabetes. Calibration analysis showed that 9 of 13
study populations $(69\%)$ had a slope of observed to
predicted risk between 0.80 and 1.25. Discrimination was
similar in 18 study populations in 9 external validation
cohorts; calibration showed that 16 of 18 $(89\%)$ had a
slope of observed to predicted risk between 0.80 and
1.25.Equations for predicting risk of incident chronic
kidney disease developed from more than 5 million
individuals from 34 multinational cohorts demonstrated high
discrimination and variable calibration in diverse
populations. Further study is needed to determine whether
use of these equations to identify individuals at risk of
developing chronic kidney disease will improve clinical care
and patient outcomes.},
cin = {C070},
ddc = {610},
cid = {I:(DE-He78)C070-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:31703124},
doi = {10.1001/jama.2019.17379},
url = {https://inrepo02.dkfz.de/record/147513},
}