title: Development and validation of a general population renal risk score.
abstract: OBJECTIVE
  There is a need for prediction scores that identify individuals at increased risk for developing progressive chronic kidney disease (CKD). Therefore, this study was performed to develop and validate a "renal risk score" for the general population. Design, setting, participants, & measurements For this study we used data from the PREVEND (Prevention of Renal and Vascular ENdstage Disease) study, a prospective population-based cohort study with a median follow-up of 6.4 years. Participants with two or three consecutive estimated GFR (eGFR) measurements during follow-up were included. Participants within the group who had the most renal function decline (top 20% of the total population) and had an eGFR value <60 ml/min per 1.73 m² during follow-up were defined as having progressive CKD. Possible predictors for progressive CKD were selected on the basis of univariable logistic regression analyses.
  
  
  RESULTS
  A final prediction model was built using backward logistic regression analysis. Besides baseline eGFR, the model contained age, urinary albumin excretion, systolic BP, C-reactive protein, and known hypertension. The area under the receiver operating characteristic (ROC) curve was 0.84. We performed internal validation by using a bootstrapping procedure. As expected, after the regression coefficients were corrected for optimism, the area under the ROC curve was still 0.84. For clinical use we divided all predictors in meaningful clinical categories to develop a score chart. The area under the ROC curve was 0.83, indicating the high discriminative value of this model.
  
  
  CONCLUSIONS
  Given the high internal validity of this renal risk score, this score can be helpful to identify individuals at increased risk for progressive CKD.
authors: Division of Nephrology, Department of Medicine, University Medical Center Groningen, University Hospital Groningen, Groningen, The Netherlands.
authors: Nynke
authors: N
authors: Halbesma
authors: Desiree F
authors: DF
authors: Jansen
authors: Martijn W
authors: MW
authors: Heymans
authors: Ronald P
authors: RP
authors: Stolk
authors: Paul E
authors: PE
authors: de Jong
authors: Ronald T
authors: RT
authors: Gansevoort
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein