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Zhang Q, Zhang J, Lei L, Liang H, Li Y, Lu J, Zhou S, Li G, Zhang X, Chen Y, Pan J, Lu X, Chen Y, Lin X, Li X, An S, Xiu J. Nomogram to predict risk of incident chronic kidney disease in high-risk population of cardiovascular disease in China: community-based cohort study. BMJ Open 2021; 11:e047774. [PMID: 34772745 PMCID: PMC8593715 DOI: 10.1136/bmjopen-2020-047774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
AIMS To develop a nomogram for incident chronic kidney disease (CKD) risk evaluation among community residents with high cardiovascular disease (CVD) risk. METHODS In this retrospective cohort study, 5730 non-CKD residents with high CVD risk participating the National Basic Public Health Service between January 2015 and December 2020 in Guangzhou were included. Endpoint was incident CKD defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 during the follow-up period. The entire cohorts were randomly (2:1) assigned to a development cohort and a validation cohort. Predictors of incident CKD were selected by multivariable Cox regression and stepwise approach. A nomogram based on these predictors was developed and evaluated with concordance index (C-index) and area under curve (AUC). RESULTS During the median follow-up period of 4.22 years, the incidence of CKD was 19.09% (n=1094) in the entire cohort, 19.03% (727 patients) in the development cohort and 19.21% (367 patients) in the validation cohort. Age, body mass index, eGFR 60-89 mL/min/1.73 m2, diabetes and hypertension were selected as predictors. The nomogram demonstrated a good discriminative power with C-index of 0.778 and 0.785 in the development and validation cohort. The 3-year, 4-year and 5-year AUCs were 0.817, 0.814 and 0.834 in the development cohort, and 0.830, 0.847 and 0.839 in the validation cohort. CONCLUSION Our nomogram based on five readily available predictors is a reliable tool to identify high-CVD risk patients at risk of incident CKD. This prediction model may help improving the healthcare strategies in primary care.
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Affiliation(s)
- Qiuxia Zhang
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Jingyi Zhang
- Community Health Service Center, Zengjiang Avenue, Guangzhou, Guangdong, China
| | - Li Lei
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Hongbin Liang
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Yun Li
- Department of Public Health, Xintang Hospital, Guangzhou, Guangdong, China
| | - Junyan Lu
- Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Guangzhou, Guangdong, China
| | - Shiyu Zhou
- Department of Biostatistics, Southern Medical University School of Public Health, Guangzhou, Guangdong, China
| | - Guodong Li
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xinlu Zhang
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Yaode Chen
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Jiazhi Pan
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xiangqi Lu
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Yejia Chen
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xinxin Lin
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xiaobo Li
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Shengli An
- Department of Biostatistics, Southern Medical University School of Public Health, Guangzhou, Guangdong, China
| | - Jiancheng Xiu
- Department of Cardiology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
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