A Predictive Nomogram for Selective Screening of Chronic Kidney Disease: A Population-Based Study

被引:0
作者
Vo, Nghia H. [1 ]
Pham, Bui V. [2 ]
Nguyen, Nghia N. [1 ]
Nguyen, Bao T. [1 ]
机构
[1] Can Tho Univ Med & Pharm, 179 Nguyen Van Cu St, Can Tho City 900000, Vietnam
[2] Pham Ngoc Thach Univ Med, Nguyen Tri Phuong Hosp, 468 Nguyen Trai St,Ward 8, Ho Chi Minh City 70000, Vietnam
关键词
chronic kidney disease; predictive model; nomogram; risk factors; RISK-FACTORS; ADULT-POPULATION; PREVALENCE; MANAGEMENT; HEALTH;
D O I
10.1177/20543581241309979
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Chronic kidney disease (CKD) is associated with disability, low quality of life, and mortality. However, most cases are asymptomatic, often detected incidentally, or only recognized when they have progressed to the later stages with complications. The present study aimed to determine the prevalence of CKD and develop a predictive nomogram for CKD in Vietnamese adults.Methods: This cross-sectional, population-based study involved 533 men and 957 women aged 18 years and older who were screened for CKD. The CKD was diagnosed using the albumin-to-creatinine ratio and/or estimated glomerular filtration rate by the CKD-EPI 2009 equation based on serum creatinine, age, gender, and race (these tests included a baseline measurement and a repeat measurement after 3 months) according to the KDIGO 2012 guideline. We used the Bayesian Model Averaging method to identify the optimal model for predicting CKD. A predictive nomogram was also developed to enable risk prediction.Results: The overall CKD prevalence was 13.1% (95% confidence interval [CI] = 11.6-14.6), with a prevalence of 11.8% (95% CI = 9.1-14.5) in men and 13.8% (95% CI = 11.6-16) in women. The optimal model for predicting CKD included age (odds ratio [OR] per 5-year increase = 1.19; 95% CI = 1.11-1.28), hypertension (OR = 2.08; 95% CI = 1.50-2.89), and diabetes (OR = 1.69; 95% CI = 1.18-2.43). The area under the receiver operating characteristic curve was 0.7, with a 95% CI ranging from 0.65 to 0.73.Conclusions: The CKD is relatively common among Vietnamese adults. A simple model-including age, hypertension, and diabetes-is helpful for the selective screening of CKD in Vietnamese individuals. Objectifs: L'insuffisance r & eacute;nale chronique (IRC) est associ & eacute;e & agrave; de l'invalidit & eacute;, & agrave; une faible qualit & eacute; de vie et & agrave; un risque accru de mortalit & eacute;. La plupart des cas sont asymptomatiques et d & eacute;tect & eacute;s souvent de fa & ccedil;on accidentelle ou lorsque la maladie a progress & eacute; vers un stade avanc & eacute; avec complications. Cette & eacute;tude visait & agrave; d & eacute;terminer la pr & eacute;valence de l'IRC chez les adultes d'origine vietnamienne et & agrave; d & eacute;velopper un nomogramme pr & eacute;dictif de la maladie.M & eacute;thodologie: Cette & eacute;tude populationnelle transversale portait sur des adultes, 533 hommes et 957 femmes, ayant subi un d & eacute;pistage de l'IRC. Le diagnostic a & eacute;t & eacute; pos & eacute; conform & eacute;ment aux directives KDIGO de 2012, soit par le calcul du rapport albumine/cr & eacute;atinine et/ou du d & eacute;bit de filtration glom & eacute;rulaire estim & eacute; avec l'& eacute;quation CKD-EPI de 2009, laquelle tient compte de la cr & eacute;atinin & eacute;mie, de l'& acirc;ge, du sexe et de l'origine ethnique (valeurs des tests obtenues par une mesure initiale et une mesure r & eacute;p & eacute;t & eacute;e apr & egrave;s trois mois). Nous avons utilis & eacute; la m & eacute;thode de la moyenne bay & eacute;sienne pour d & eacute;terminer le mod & egrave;le pr & eacute;dictif optimal pour l'IRC, puis nous avons d & eacute;velopp & eacute; un nomogramme permettant la pr & eacute;diction du risque.R & eacute;sultats: La pr & eacute;valence de l'IRC dans la population & eacute;tudi & eacute;e & eacute;tait de 13,1 % (intervalle de confiance & agrave; 95 % [IC95]: 11,6-14,6); elle & eacute;tait de 11,8 % chez les hommes (IC95: 9,1-14,5) et de 13,8 % chez les femmes (IC95: 11,6-16,0). Le mod & egrave;le optimal pour pr & eacute;dire l'IRC tenait compte de l'& acirc;ge (rapport de cotes [RC] par augmentation du risque sur 5 ans: 1,19; IC95: 1,11-1,28), de l'hypertension (RC: 2,08; IC95: 1,50-2,89) et du diab & egrave;te (RC: 1,69; IC95: 1,18-2,43). La surface sous la courbe ROC & eacute;tait de 0,7 (IC95: 0,65-0,73).Conclusion: L'IRC est relativement fr & eacute;quente chez les adultes d'origine vietnamienne. Un mod & egrave;le simple tenant compte de l'& acirc;ge, de l'hypertension et du diab & egrave;te est utile pour le d & eacute;pistage s & eacute;lectif de l'IRC dans cette population.
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