More work needed on models to predict risk of chronic kidney disease

November 20, 2012

Models used for predicting the likelihood of individuals developing chronic kidney disease and for predicting disease progression in people who already have the condition are useful tools but not yet robust enough to help inform clinical guidelines, according to a study published in this week's PLOS Medicine.

Chronic kidney disease is a common but serious condition which can lead to kidney failure. The condition cannot be cured but progression of the disease can be slowed by controlling high blood pressure and diabetes, both causes of chronic kidney disease, and by adopting a healthy lifestyle. Identifying people who are at risk of developing chronic kidney disease is therefore of utmost importance and researchers are currently using "risk models"--a method to assess the risk of developing the condition--as currently, there is no screening test for chronic kidney disease.

Justin Echouffo-Tcheugui from Emory University in Atlanta, Georgia, and Andre Kengne from the South African Medical Research Council in Capetown reviewed published studies to test the accuracy and suitability of existing risk models for chronic kidney disease. They found that although the risk models were able to separate people with chronic kidney disease from those without the condition (discriminatory ability) not all of the models checked whether the proportion of the population predicted to develop chronic kidney disease (based on the average predictive risk calculated by the models) actually developed the condition (calibration).

The authors also found that few studies tested the risk model in other groups (other than the specific study group) and most of the models were only tested in Caucasian populations.

The authors say: "This review suggests that risk models for predicting chronic kidney disease or its progression have a modest-to-acceptable discriminatory performance, but would need to be better calibrated and externally validated--and the impact of their use on outcomes assessed--before these are incorporated in guidelines."

In an accompanying Perspective article, Maarten Taal (uninvolved in the study) from the Royal Derby Hospital in the UK stresses the importance of a potential screening test for chronic kidney disease but says: "Efforts to develop risk prediction tools to target screening towards those at higher risk are likely to improve the efficiency of screening programmes, but as noted by Echouffo-Tcheugui and Kegne, published risk prediction formulae require further development and external validation."

Taal continues: "In the absence of evidence showing benefit from population screening for chronic kidney disease most guidelines recommend that testing should be directed to people with known risk factors, but in light of improved diagnostic tests and novel risk prediction tools, further research is required to establish the most cost-effective approach."
-end-
Research Article:

Funding: No direct funding was received for this study. The authors were personally salaried by their institutions during the period of writing, though no specific salary was set aside or given for the writing of this paper.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Echouffo-Tcheugui JB, Kengne AP (2012) Risk Models to Predict Chronic Kidney Disease and Its Progression: A Systematic Review. PLOS Med 9(11): e1001344. doi:10.1371/journal.pmed.1001344

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001344

CONTACT:

Justin B. Echouffo-Tcheugui
Rollins School of Public Health, Emory University,
Atlanta, Georgia, United States of America
jechouf@emory.edu

Andre P. Kengne
South African Medical Research Council
Cape Town, South Africa
andre.kengne@mrc.ac.za

Perspective article:

Funding: No specific funding was received for writing this article.

Competing Interests: The author has declared that no competing interests exist.

Citation: Taal MW (2012) Screening for Chronic Kidney Disease: Preventing Harm or Harming the Healthy? PLOS Med 9(11): e1001345. doi:10.1371/journal.pmed.1001345

IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER (THIS LINK WILL BECOME LIVE WHEN THE EMBARGO LIFTS):

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001345

CONTACT:Maarten W. Taal
Royal Derby Hospital, Uttoxeter Road, Derby
Derbyshire, United Kingdom
maarten.taal1@nhs.net

PLOS

Related Chronic Kidney Disease Articles from Brightsurf:

How to ensure patients manage their chronic kidney disease
A Singapore study finds patients with chronic kidney disease need tailored nutrition guidance, as well as better communication with doctors and family support, to empower them to manage their condition.

Children with chronic kidney disease have outsized health burden
Chronically ill children with kidney disease may spend more time in the hospital, incur larger health care costs and have a higher risk of death compared to pediatric patients hospitalized for other chronic conditions, a new study suggests.

Your neighborhood may raise your risk of chronic kidney disease
A neighborhood's overall socioeconomic status, including income and education-level, may influence its residents' risk of chronic kidney disease, according to a study recently published in SSM Population Health by researchers from Drexel University's Dornsife School of Public Health.

These lifestyle choices can reduce the risk of chronic kidney disease
Active lifestyle choices such as eating vegetables, exercising and quitting smoking can reduce the risk of chronic kidney disease, a new study led by researchers at Karolinska Institutet in Sweden and Griffith University in Australia, reports.

SGLT2 inhibitors can slow progression of chronic kidney disease
The CREDENCE trial [3] provided evidence that the SGLT2 inhibitor Canagliflozin slows the progression of CKD in individuals with type 2 diabetes (T2D) and CKD with albuminuria.

Antioxidant agent may prevent chronic kidney disease and Parkinson's disease
Researchers from Osaka University developed a novel dietary silicon-based antioxidant agent with renoprotective and neuroprotective effects.

New study provides insight into chronic kidney disease
Researchers have further analyzed a known signaling pathway they believe brings them one step closer to understanding the complex physiology of patients with chronic kidney disease (CKD), which might provide a path to new treatment options.

Predicting risk of chronic kidney disease
Data from about 5 million people (with and without diabetes) in 28 countries were used to develop equations to help identify people at increased five-year risk of chronic kidney disease, defined as reduced estimated glomerular filtration rate (eGFR).

New tool predicts five-year risk of chronic kidney disease
A new risk calculator tool that uses a mix of variables including age, hypertension, and diabetes status can be used to predict accurately whether someone is likely to develop chronic kidney disease within five years.

Gap in care found for patients with chronic kidney disease: study
Millions of Canadians living with chronic kidney disease (CKD) may be going without critical testing from their primary care practitioners that would give them a good idea of the severity of the disease so they could intervene earlier with more appropriate care, according to a new study.

Read More: Chronic Kidney Disease News and Chronic Kidney Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.