Key result
Novel risk model predicts incident ESRD in type 2 diabetes with up to ~0.92 AUC.
Why the study?
A prediction model for end-stage renal disease in patients with type 2 diabetes was needed to enable early prevention and risk stratification.
Cohort (n=24,104)
Yes
Effect estimate: AUC 0.92 (3-year), 0.87 (5-year), and 0.80 (8-year) in validation set
A newly developed risk prediction model demonstrated good accuracy and discriminatory ability for predicting 3-, 5-, and 8-year ESRD risk in Chinese patients with type 2 diabetes.
May aid ESRD risk stratification in type 2 diabetes; leaves open prospective validation before clinical use.
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.
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Lin et al. (2017) conducted a cohort in Type 2 diabetes (n=24,104). Clinical risk prediction model (including age, creatinine, HbA1c variation, BP variation, etc.) was evaluated on Incident end-stage renal disease (ESRD) at 3, 5, and 8 years (AUC 0.92 (3-year), 0.87 (5-year), and 0.80 (8-year) in validation set). A newly developed risk prediction model incorporating clinical and laboratory variables demonstrated excellent discriminatory ability for predicting 3-year, 5-year, and 8-year incident ESRD in patients with type 2 diabetes, with validation set AUCs of 0.92, 0.87, and 0.80, respectively.
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