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Predicting the risk of end-stage renal disease in the population-based setting: a retrospective case-control study.
Johnson, Eric S; Smith, David H; Thorp, Micah L; Yang, Xiuhai; Juhaeri, Juhaeri.
Afiliação
  • Johnson ES; The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA. eric.s.johnson@kpchr.org
BMC Nephrol ; 12: 17, 2011 May 05.
Article em En | MEDLINE | ID: mdl-21545746
ABSTRACT

BACKGROUND:

Previous studies of predictors of end-stage renal disease (ESRD) have

limitations:

(1) some focused on patients with clinically recognized chronic kidney disease (CKD); (2) others identified population-based patients who developed ESRD, but lacked earlier baseline clinical measures to predict ESRD. Our study was designed to address these limitations and to identify the strength and precision of characteristics that might predict ESRD pragmatically for decision-makers--as measured by the onset of renal replacement therapy (RRT).

METHODS:

We conducted a population-based, retrospective case-control study of patients who developed ESRD and started RRT. We conducted the study in a health maintenance organization, Kaiser Permanente Northwest (KPNW). The case-control study was nested within the adult population of KPNW members who were enrolled during 1999, the baseline period. Cases and their matched controls were identified from January 2000 through December 2004. We evaluated baseline clinical characteristics measured during routine care by calculating the adjusted odds ratios and their 95% confidence intervals after controlling for matching characteristics age, sex, and year.

RESULTS:

The rate of RRT in the cohort from which we sampled was 58 per 100,000 person-years (95% CI, 53 to 64). After excluding patients with missing data, we analyzed 350 cases and 2,114 controls. We identified the following characteristics that predicted ESRD with odds ratios ≥ 2.0 eGFR<60 mL/min/1.73 m(2) (OR = 20.5; 95% CI, 11.2 to 37.3), positive test for proteinuria (OR = 5.0; 95% CI, 3.5 to 7.1), hypertension (OR = 4.5; 95% CI, 2.5 to 8.0), gout/positive test for uric acid (OR = 2.5; 95% CI, 1.8 to 3.5), peripheral vascular disease (OR = 2.2; 95% CI, 1.4 to 3.6), congestive heart failure (OR = 2.1; 95% CI, 1.4 to 3.3), and diabetes (OR = 2.1; 95% CI, 1.5 to 2.9).

CONCLUSIONS:

The clinical characteristics needed to predict ESRD--for example, to develop a population-based, prognostic risk score--were often documented during routine care years before patients developed ESRD and required RRT.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia de Substituição Renal / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia de Substituição Renal / Falência Renal Crônica Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Nephrol Assunto da revista: NEFROLOGIA Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Estados Unidos