Development and validation of a risk prediction model for end-stage renal disease in patients with type 2 diabetes

• Published in: Scientific reports Vol. 7; no. 1; p. 10177
• Main Authors: Lin, Cheng-Chieh, Li, Chia-Ing, Liu, Chiu-Shong, Lin, Wen-Yuan, Lin, Chih-Hsueh, Yang, Sing-Yu, Li, Tsai-Chung
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 31.08.2017; Nature Publishing Group
• Subjects: 692/163/2743/137/773; 692/4022/1585/104/1586; Adult; Aged; Aged, 80 and over; Antihypertensives; Area Under Curve; Blood pressure; China - epidemiology; Creatinine; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; End-stage renal disease; Female; Humanities and Social Sciences; Humans; Hyperlipidemia; Kidney diseases; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - epidemiology; Kidney Failure, Chronic - etiology; Kidney transplantation; Male; Middle Aged; Models, Theoretical; multidisciplinary; Prediction models; Random Allocation; Retinopathy; Retrospective Studies; Risk Assessment; Science; Science (multidisciplinary); China
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-09243-9

The aim of this study is to develop a prediction model for ESRD in patients with type 2 diabetes. A retrospective cohort study was conducted, consisting of 24,104 Chinese patients with type 2 diabetes. We adopted the procedures proposed by the Framingham Heart Study to develop a prediction model for ESRD. Participants were randomly assigned to the derivation and validation sets at a 2:1 ratio. The Cox proportional hazard regression model was used for model development. A total of 813 and 402 subjects (5.06% and 5.00%, respectively) developed ESRD in the derivation and validation sets over a mean follow-up period of 8.3 years. The risk-scoring systems included age, gender, age of diabetes onset, combined statuses of blood pressure and anti-hypertensive medication use, creatinine, variation in HbA1c, variation in systolic blood pressure, diabetes retinopathy, albuminuria, anti-diabetes medications, and combined statuses of hyperlipidemia and anti-hyperlipidemia medication use. The area under curves of 3-year, 5-year, and 8-year ESRD risks were 0.90, 0.86, and 0.81 in the derivation set, respectively. This risk score model can be used as screening for early prevention. The risk prediction for 3-year, 5-year, and 8-year period demonstrated good predictive accuracy and discriminatory ability.