Key result
The QKidney scores demonstrated good discrimination for predicting the 5-year risk of moderate-severe kidney disease (AUROC 0.875) and end-stage kidney failure in a large UK primary care cohort.
Why the study?
Does the QKidney score accurately predict the 5-year risk of moderate-severe kidney disease and end-stage kidney failure in a UK primary care population?
Cohort (n=1,593,506)
Yes
Does the QKidney score accurately predict the 5-year risk of moderate-severe kidney disease and end-stage kidney failure in a UK primary care population?
The QKidney scores accurately predict the 5-year risk of moderate-severe kidney disease and end-stage kidney failure in UK primary care, with the model excluding serum creatinine being preferred for routine use due to high rates of missing laboratory data.
Supports QKidney use for UK primary care risk stratification; extends validation yet leaves open need for outcome trials before routine adoption.
BACKGROUND: Chronic kidney disease is a major health concern that, if left untreated, may progress to end-stage kidney failure (ESKF). Identifying individuals at an increased risk of kidney disease and who might benefit from a therapeutic or preventive intervention is an important challenge. AIM: To evaluate the performance of the QKidney® scores for predicting 5-year risk of developing moderate-severe kidney disease and ESKF in an independent UK cohort of patients from general practice records. DESIGN AND SETTING: Prospective cohort study to evaluate the performance of two risk scores for kidney disease in 364 practices from the UK, contributing to The Health Improvement Network (THIN) database. METHOD: Data were obtained from 1.6 million patients registered with a general practice surgery between 1 January 2002 and 1 July 2008, aged 35-74 years, with 43,186 incident cases of moderate-severe kidney disease and 2663 incident cases of ESKF. This is the first recorded evidence of moderate-severe chronic kidney and ESKF as recorded in general practice records. RESULTS: The results from this independent and external validation of QKidney scores indicate that both scores showed good performance data for both moderate-severe kidney disease and ESKF, on a large cohort of general practice patients. Discrimination and calibration statistics were better for models including serum creatinine; however, there were considerable amounts of missing data for serum creatinine. QKidney scores both with and without serum creatinine were well calibrated. CONCLUSION: QKidney scores have been shown to be useful tools to predict the 5-year risk of moderate-severe kidney disease and ESKF in the UK.
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Collins et al. (2012) conducted a cohort in Chronic kidney disease (n=1,593,506). QKidney risk scores was evaluated on 5-year risk of moderate-severe CKD and ESKF (discrimination and calibration) (AUROC 0.875). The QKidney scores demonstrated good discrimination for predicting the 5-year risk of moderate-severe kidney disease (AUROC 0.875) and end-stage kidney failure in a large UK primary care cohort.
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