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Predicting the risk of end-stage renal disease in the population-based setting: a retrospective case-control study.
BMC Nephrol. 2011 May 05; 12:17.BN

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.

Authors+Show Affiliations

The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA. eric.s.johnson@kpchr.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21545746

Citation

Johnson, Eric S., et al. "Predicting the Risk of End-stage Renal Disease in the Population-based Setting: a Retrospective Case-control Study." BMC Nephrology, vol. 12, 2011, p. 17.
Johnson ES, Smith DH, Thorp ML, et al. Predicting the risk of end-stage renal disease in the population-based setting: a retrospective case-control study. BMC Nephrol. 2011;12:17.
Johnson, E. S., Smith, D. H., Thorp, M. L., Yang, X., & Juhaeri, J. (2011). Predicting the risk of end-stage renal disease in the population-based setting: a retrospective case-control study. BMC Nephrology, 12, 17. https://doi.org/10.1186/1471-2369-12-17
Johnson ES, et al. Predicting the Risk of End-stage Renal Disease in the Population-based Setting: a Retrospective Case-control Study. BMC Nephrol. 2011 May 5;12:17. PubMed PMID: 21545746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting the risk of end-stage renal disease in the population-based setting: a retrospective case-control study. AU - Johnson,Eric S, AU - Smith,David H, AU - Thorp,Micah L, AU - Yang,Xiuhai, AU - Juhaeri,Juhaeri, Y1 - 2011/05/05/ PY - 2011/01/04/received PY - 2011/05/05/accepted PY - 2011/5/7/entrez PY - 2011/5/7/pubmed PY - 2011/9/16/medline SP - 17 EP - 17 JF - BMC nephrology JO - BMC Nephrol VL - 12 N2 - 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. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/21545746/Predicting_the_risk_of_end_stage_renal_disease_in_the_population_based_setting:_a_retrospective_case_control_study_ L2 - https://www.biomedcentral.com/1471-2369/12/17 DB - PRIME DP - Unbound Medicine ER -