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Risk score for first-screening of prevalent undiagnosed chronic kidney disease in Peru: the CRONICAS-CKD risk score

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dc.contributor.author Carrillo-Larco, Rodrigo M.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Gilman, Robert H.
dc.contributor.author Medina-Lezama, Josefina
dc.contributor.author Chirinos-Pacheco, Julio A.
dc.contributor.author Muñoz-Retamozo, Paola V.
dc.contributor.author Smeeth, Liam
dc.contributor.author Checkley, William
dc.contributor.author Bernabe-Ortiz, Antonio
dc.contributor.author CRONICAS Cohort Study Group
dc.date.accessioned 2019-01-25T16:03:19Z
dc.date.available 2019-01-25T16:03:19Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4748
dc.description.abstract BACKGROUND: Chronic Kidney Disease (CKD) represents a great burden for the patient and the health system, particularly if diagnosed at late stages. Consequently, tools to identify patients at high risk of having CKD are needed, particularly in limited-resources settings where laboratory facilities are scarce. This study aimed to develop a risk score for prevalent undiagnosed CKD using data from four settings in Peru: a complete risk score including all associated risk factors and another excluding laboratory-based variables. METHODS: Cross-sectional study. We used two population-based studies: one for developing and internal validation (CRONICAS), and another (PREVENCION) for external validation. Risk factors included clinical- and laboratory-based variables, among others: sex, age, hypertension and obesity; and lipid profile, anemia and glucose metabolism. The outcome was undiagnosed CKD: eGFR < 60 ml/min/1.73m2. We tested the performance of the risk scores using the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive/negative predictive values and positive/negative likelihood ratios. RESULTS: Participants in both studies averaged 57.7 years old, and over 50% were females. Age, hypertension and anemia were strongly associated with undiagnosed CKD. In the external validation, at a cut-off point of 2, the complete and laboratory-free risk scores performed similarly well with a ROC area of 76.2% and 76.0%, respectively (P = 0.784). The best assessment parameter of these risk scores was their negative predictive value: 99.1% and 99.0% for the complete and laboratory-free, respectively. CONCLUSIONS: The developed risk scores showed a moderate performance as a screening test. People with a score of ≥ 2 points should undergo further testing to rule out CKD. Using the laboratory-free risk score is a practical approach in developing countries where laboratories are not readily available and undiagnosed CKD has significant morbidity and mortality. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartof urn:issn:1471-2369
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Severity of Illness Index en_US
dc.subject Adult en_US
dc.subject Aged en_US
dc.subject Chronic kidney disease en_US
dc.subject Cohort Studies en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Female en_US
dc.subject Follow-Up Studies en_US
dc.subject Humans en_US
dc.subject Hypertension/diagnosis/epidemiology/physiopathology en_US
dc.subject Kidney en_US
dc.subject Latin America en_US
dc.subject Male en_US
dc.subject Middle Aged en_US
dc.subject Peru/epidemiology en_US
dc.subject Prevalence en_US
dc.subject Renal Insufficiency, Chronic/diagnosis/epidemiology/physiopathology en_US
dc.subject Risk assessment en_US
dc.subject Risk Factors en_US
dc.title Risk score for first-screening of prevalent undiagnosed chronic kidney disease in Peru: the CRONICAS-CKD risk score en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12882-017-0758-4
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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