Home About Us Media Kit Subscriptions Links Forum
 
APPEARED IN


View All Articles

Download PDF

FAMOUS INTERVIEWS

Directories:

SCHOLARSHIPS & GRANTS

HELP WANTED

Tutors

Workshops

Events

Sections:

Books

Camps & Sports

Careers

Children’s Corner

Collected Features

Colleges

Cover Stories

Distance Learning

Editorials

Famous Interviews

Homeschooling

Medical Update

Metro Beat

Movies & Theater

Museums

Music, Art & Dance

Special Education

Spotlight On Schools

Teachers of the Month

Technology

Archives:

2014

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

1995-2000


MARCH 2009

Simple Model Predicts Those at Risk for Chronic Kidney Disease

Traditionally, doctors have had no clear way to predict which of their patients might be headed down the road to chronic kidney disease (CKD). Now, researchers at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and the University of North Carolina at Chapel Hill have created a simple eight-point risk factor checklist to do just that.

As reported recently in the Archives of Internal Medicine, the model accurately stratifies middle-aged and older patients at high risk for newly diagnosed CKD, which involves a gradual, even fatal loss of kidney function over time.

According to the National Kidney Foundation, 26 million American adults have CKD and millions of others are at increased risk.

“These patients are often battling concurrent conditions such as diabetes or heart disease, so anything we can do to predict and then lower their risk for kidney disease will be invaluable,” says study senior author Dr. Phyllis A. August, the Ralph A. Baer Professor of Medical Research at Weill Cornell Medical College, and an internist and nephrologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

In their research, Dr. August and colleagues combined data from two major studies, the Atherosclerosis Risk in Communities trial and the Cardiovascular Health Study, which together total 14,155 men and women aged 45 years or older. All of the participants had a glomerular filtration rate exceeding 60 mL/min/1.73m2 at the beginning of the study—indicating their kidneys were functioning at a normal healthy level at that time.

The researchers then tracked the health of the participants during a follow-up of up to nine years, recording those participants whose filtration rate fell below the healthy 60 mL/min/1.73 m2 threshold. They also tracked a wide variety of risk factors thought important to the onset of CKD.

Overall, a total of 1,605 participants from the two cohorts went on to develop CKD over the course of follow-up.

“We discovered that a scoring system that included eight key risk factors—older age, anemia, female sex, hypertension, diabetes, peripheral vascular disease and any history of congestive heart failure or cardiovascular disease—accurately predicted which of the older patients would proceed to CKD and which would not,” says study co-author Dr. Heejung Bang, assistant professor in the Division of Biostatistics and Epidemiology in the Department of Public Health at Weill Cornell Medical College.

In the scoring system, each time a patient answers “yes” to having one of the eight risk factors, they gain anywhere from one to three points. Older age (at or over 70) was of highest predictive significance, so it added three points to the score. Risk factors other than age each added one point.

Scoring a total of just three points in the model captured 70 percent of those patients who would go on to develop CKD over the next 10 years. For people scoring three, the model had 91 percent sensitivity for assessing how well the test identified people who would later go on to develop CKD, and a specificity of 28 percent for assessing how well the test identified those who would not develop the disease. For those scoring a six on the test, sensitivity and specificity were 93 percent and 25 percent, respectively.

The new algorithm may have an even broader impact. “As it becomes more clear as to just what conditions are the prime factors behind kidney dysfunction—factors such as diabetes, hypertension and heart disease -- this tool should guide policymakers and researchers to find better and more cost-effective ways to target this devastating disease,” notes Dr. August.#

COMMENT ON THIS ARTICLE

Name:

Email:
Show email
City:
State:

 


 

 

 

Education Update, Inc.
All material is copyrighted and may not be printed without express consent of the publisher. © 2009.