Key result
A prediction nomogram incorporating six clinical factors predicted the 5-year risk of kidney dysfunction with a validation C-index of 0.763 (95% CI 0.704-0.823).
Why the study?
Patients with hypertension and glucose metabolism disorder are at high risk of developing kidney dysfunction, creating a need for a prediction model to assess individual 5-year risk.
Cohort (n=1,961)
A novel nomogram incorporating six common clinical factors accurately predicts the 5-year risk of kidney dysfunction in patients with hypertension and glucose metabolism disorder.
Answers are grounded in this paper and cite their sources.
Nomogram may support KD risk stratification in hypertensives with GMD; leaves open external validation before clinical adoption.
Purpose: Patients with hypertension and glucose metabolism disorder (GMD) are at high risk of developing kidney dysfunction (KD). Therefore, we aimed to develop a nomogram for predicting individuals’ 5-year risk of KD in hypertensives with GMD. Patients and Methods: In total, 1961 hypertensives with GMD were consecutively included. Baseline data were extracted from medical electronic system, and follow-up data were obtained using annual health check-ups or hospital readmission. KD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m 2 . Subjects were randomly divided into training and validation sets with a ratio of 7 to 3. Least absolute shrinkage and selection operator method was used to identify potential predictors. Cox proportional hazard model was applied to build a nomogram for predicting KD risk. The discriminative ability, calibration and usefulness of the model were evaluated. The prediction model was verified by internal validation. Results: During the follow-up of 5351 person-years with a median follow-up of 32 (range: 3– 91) months, 130 patients developed KD. Age, sex, ethnicity, hemoglobin A1c, uric acid, and baseline eGFR were identified as significant predictors for incident KD and used for establishing nomogram. The prediction model displayed good discrimination with C-index of 0.770 (95% CI: 0.712– 0.828) and 0.763 (95% CI: 0.704– 0.823) in training and validation sets, respectively. Calibration curve indicated good agreement between the predicted and actual probabilities. The decision curve analysis demonstrated that the model was clinically useful. Conclusion: The prediction nomogram, including six common easy-to-obtain factors, shows good performance for predicting 5-year risk of KD in hypertensives with GMD. This quantitative tool could help clinicians, and even primary care providers, recognize potential KD patients early and make strategy for prevention and management.
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A 2022 study conducted a cohort in Hypertension and glucose metabolism disorder (n=1,961). Clinical risk factors (age, sex, ethnicity, hemoglobin A1c, uric acid, and baseline eGFR) was evaluated on Kidney dysfunction (eGFR < 60 mL/min/1.73m2) (C-index 0.763, 95% CI 0.704-0.823). A prediction nomogram incorporating six clinical factors predicted the 5-year risk of kidney dysfunction with a validation C-index of 0.763 (95% CI 0.704-0.823).
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