title: Evaluation of the Framingham Heart Study risk factors and risk score for incident chronic kidney disease at 10 years in a Thai general population.
abstract: OBJECTIVE
  Asians have some of the highest rates of end-stage renal disease, but there is limited information on the risk factors for chronic kidney disease (CKD) in the Asian general population. A risk score for incident CKD for the general population has been developed from the US Framingham Heart Study (FHS) Offspring cohort. This score has been validated on Caucasians and African-Americans, but has not been tested on Asians. We aimed to assess the importance of the FHS risk factors and the performance of the FHS risk score in predicting incident CKD at 10 years in a Thai community-based population.
  
  
  METHODS
  This is a prospective study to evaluate the risk factors and the performance of the FHS risk score comprising of age, diabetes, hypertension, proteinuria, and GFR in predicting incident CKD at 10 years in employees (n = 2568) of the Electric Generating Authority of Thailand.
  
  
  RESULTS
  After excluding subjects with CKD at baseline, 10.4% developed incident CKD defined by the MDRD equation and 10.0% by the CKD-EPI equation. Diabetes, hypertension, and baseline GFR were strong predictors of incident CKD, but proteinuria was not. The agreement between the observed rates and the rates predicted by the FHS risk score was not high (MDRD: χ2= 30, P < 0.001; CKD-EPI: χ2= 256, P < 0.001), and the discrimination of incident CKD was modest (AUROC (95% CI): MDRD, 0.69 (0.66-0.73); CKD-EPI, 0.63 (0.57-0.65).
  
  
  CONCLUSIONS
  Although diabetes, hypertension, and baseline GFR were important risk factors, the FHS risk score might not be sufficiently accurate at estimating incident CKD in an Asian general population.
authors.affiliation: Cardiovascular and Metabolic Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Krittika
authors.initials: K
authors.lastname: Saranburut
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Prin
authors.initials: P
authors.lastname: Vathesatogkit
authors.affiliation: Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Anchalee
authors.initials: A
authors.lastname: Chittamma
authors.affiliation: Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Somlak
authors.initials: S
authors.lastname: Vanavanan
authors.affiliation: Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Nisakron
authors.initials: N
authors.lastname: Thongmung
authors.affiliation: Medical and Health Office, Electricity Generating Authority of Thailand, Nonthaburi, Bang kurai, 1130, Thailand.
authors.forename: Tuangrat
authors.initials: T
authors.lastname: Tangstheanphan
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
authors.forename: Piyamitr
authors.initials: P
authors.lastname: Sritara
authors.affiliation: Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand. kitiyakc@yahoo.com.
authors.forename: Chagriya
authors.identifier: http://orcid.org/0000-0001-6340-3534
authors.initials: C
authors.lastname: Kitiyakara
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology
keywords: Asian; Chronic kidney disease; Cohort; EGAT; Framingham; Population; Risk score; Thai