Validation of a risk prediction model for early chronic kidney disease in patients with type 2 diabetes: Data from the German/Austrian Diabetes Prospective Follow-up registry

被引:2
作者
Kress, Stephan [1 ]
Bramlage, Peter [2 ]
Holl, Reinhard W. [3 ,4 ]
Moeller, Christian Dominik [5 ]
Muehldorfer, Steffen [6 ]
Reindel, Joerg [7 ]
Seufert, Jochen [8 ]
Landgraf, Rudiger [9 ]
Merker, Ludwig [10 ]
Meyhoefer, Sebastian M. [4 ,11 ]
Danne, Thomas [12 ]
Fasching, Peter [13 ]
Mertens, Peter R. [14 ]
Wanner, Christoph [15 ]
Lanzinger, Stefanie [3 ,4 ]
机构
[1] Vinzentius Hosp, Diabet Ctr, Med Clin 1, Landau, Germany
[2] Inst Pharmacol & Prevent Med, Bahnhofstr 20, D-49661 Cloppenburg, Germany
[3] Univ Ulm, Inst Epidemiol & Med Biometry, ZIBMT, Ulm, Germany
[4] German Ctr Diabet Res DZD, Munich, Germany
[5] Burgerhosp Frankfurt Am Main, Frankfurt, Germany
[6] Klinikum Bayreuth, Gastroenterol, Bayreuth, Germany
[7] Klinikum Karlsburg, Herz & Diabet Zentrum, Karlsburg, Germany
[8] Univ Freiburg, Fac Med, Med Ctr, Div Endocrinol & Diabetol,Dept Med 2, Freiburg, Germany
[9] German Diabet Fdn, Munich, Germany
[10] Diabetol MVZ, Pk Ville Eu, Haan, Germany
[11] Univ Lubeck, Inst Endocrinol & Diabet, Lubeck, Germany
[12] Kinderkrankenhaus Bult, Diabeteszentrum Kinder & Jugendl, Hannover, Germany
[13] Clin Ottakring, Med Dept Endocrinol Rheumatol & Acute Geriatr 5, Vienna, Austria
[14] Otto von Guericke Univ, Diabet & Endocrinol, Clin Nephrol & Hypertens, Magdeburg, Germany
[15] Wuerzburg Univ Clin, Div Nephrol, Wurzburg, Germany
关键词
Austria; chronic kidney disease; Germany; risk prediction model; type; 2; diabetes; EXTERNAL VALIDATION; COMPLICATIONS; IMPACT;
D O I
10.1111/dom.14925
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To validate a recently proposed risk prediction model for chronic kidney disease (CKD) in type 2 diabetes (T2D). Materials and Methods: Subjects from the German/Austrian Diabetes Prospective Follow-up (DPV) registry with T2D, normoalbuminuria, an estimated glomerular filtration rate of 60 ml/min/1.73m(2) or higher and aged 39-75 years were included. Prognostic factors included age, body mass index (BMI), smoking status and HbA1c. Subjects were categorized into low, moderate, high and very high-risk groups. Outcome was CKD occurrence. Results: Subjects (n = 10 922) had a mean age of 61 years, diabetes duration of 6 years, BMI of 31.7 kg/m(2), HbA1c of 6.9% (52 mmol/mol); 9.1% had diabetic retinopathy and 16.3% were smokers. After the follow-up (similar to 59 months), 37.4% subjects developed CKD. The area under the curve (AUC; unadjusted base model) was 0.58 (95% CI 0.57-0.59). After adjustment for diabetes and follow-up duration, the AUC was 0.69 (95% CI 0.68-0.70), indicating improved discrimination. After follow-up, 15.0%, 20.1%, 27.7% and 40.2% patients in the low, moderate, high and very high-risk groups, respectively, had developed CKD. Increasing risk score correlated with increasing cumulative risk of incident CKD over a median of 4.5 years of follow-up (P < .0001). Conclusions: The predictive model achieved moderate discrimination but good calibration in a German/Austrian T2D population, suggesting that the model may be relevant for determining CKD risk.
引用
收藏
页码:776 / 784
页数:9
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