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Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study

BACKGROUND: Since diabetes mellitus (DM) is the leading cause of end stage renal disease (ESRD), this study aimed to develop a 5-year ESRD risk prediction model among Chinese patients with Type 2 DM (T2DM) in primary care. METHODS: A retrospective cohort study was conducted on 149,333 Chinese adult...

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Autores principales: Wan, Eric Yuk Fai, Fong, Daniel Yee Tak, Fung, Colman Siu Cheung, Yu, Esther Yee Tak, Chin, Weng Yee, Chan, Anca Ka Chun, Lam, Cindy Lo Kuen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539616/
https://www.ncbi.nlm.nih.gov/pubmed/28764641
http://dx.doi.org/10.1186/s12882-017-0671-x
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author Wan, Eric Yuk Fai
Fong, Daniel Yee Tak
Fung, Colman Siu Cheung
Yu, Esther Yee Tak
Chin, Weng Yee
Chan, Anca Ka Chun
Lam, Cindy Lo Kuen
author_facet Wan, Eric Yuk Fai
Fong, Daniel Yee Tak
Fung, Colman Siu Cheung
Yu, Esther Yee Tak
Chin, Weng Yee
Chan, Anca Ka Chun
Lam, Cindy Lo Kuen
author_sort Wan, Eric Yuk Fai
collection PubMed
description BACKGROUND: Since diabetes mellitus (DM) is the leading cause of end stage renal disease (ESRD), this study aimed to develop a 5-year ESRD risk prediction model among Chinese patients with Type 2 DM (T2DM) in primary care. METHODS: A retrospective cohort study was conducted on 149,333 Chinese adult T2DM primary care patients without ESRD in 2010. Using the derivation cohort over a median of 5 years follow-up, the gender-specific models including the interaction effect between predictors and age were derived using Cox regression with a forward stepwise approach. Harrell’s C-statistic and calibration plot were applied to the validation cohort to assess discrimination and calibration of the models. RESULTS: Prediction models showed better discrimination with Harrell’s C-statistics of 0.866 (males) and 0.862 (females) and calibration power from the plots than other established models. The predictors included age, usages of anti-hypertensive drugs, anti-glucose drugs, and Hemogloblin A1c, blood pressure, urine albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Specific predictors for male were smoking and presence of sight threatening diabetic retinopathy while additional predictors for female included longer duration of diabetes and quadratic effect of body mass index. Interaction factors with age showed a greater weighting of insulin and urine ACR in younger males, and eGFR in younger females. CONCLUSIONS: Our newly developed gender-specific models provide a more accurate 5-year ESRD risk predictions for Chinese diabetic primary care patients than other existing models. The models included several modifiable risk factors that clinicians can use to counsel patients, and to target at in the delivery of care to patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0671-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-55396162017-08-03 Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study Wan, Eric Yuk Fai Fong, Daniel Yee Tak Fung, Colman Siu Cheung Yu, Esther Yee Tak Chin, Weng Yee Chan, Anca Ka Chun Lam, Cindy Lo Kuen BMC Nephrol Research Article BACKGROUND: Since diabetes mellitus (DM) is the leading cause of end stage renal disease (ESRD), this study aimed to develop a 5-year ESRD risk prediction model among Chinese patients with Type 2 DM (T2DM) in primary care. METHODS: A retrospective cohort study was conducted on 149,333 Chinese adult T2DM primary care patients without ESRD in 2010. Using the derivation cohort over a median of 5 years follow-up, the gender-specific models including the interaction effect between predictors and age were derived using Cox regression with a forward stepwise approach. Harrell’s C-statistic and calibration plot were applied to the validation cohort to assess discrimination and calibration of the models. RESULTS: Prediction models showed better discrimination with Harrell’s C-statistics of 0.866 (males) and 0.862 (females) and calibration power from the plots than other established models. The predictors included age, usages of anti-hypertensive drugs, anti-glucose drugs, and Hemogloblin A1c, blood pressure, urine albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Specific predictors for male were smoking and presence of sight threatening diabetic retinopathy while additional predictors for female included longer duration of diabetes and quadratic effect of body mass index. Interaction factors with age showed a greater weighting of insulin and urine ACR in younger males, and eGFR in younger females. CONCLUSIONS: Our newly developed gender-specific models provide a more accurate 5-year ESRD risk predictions for Chinese diabetic primary care patients than other existing models. The models included several modifiable risk factors that clinicians can use to counsel patients, and to target at in the delivery of care to patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12882-017-0671-x) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-01 /pmc/articles/PMC5539616/ /pubmed/28764641 http://dx.doi.org/10.1186/s12882-017-0671-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wan, Eric Yuk Fai
Fong, Daniel Yee Tak
Fung, Colman Siu Cheung
Yu, Esther Yee Tak
Chin, Weng Yee
Chan, Anca Ka Chun
Lam, Cindy Lo Kuen
Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title_full Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title_fullStr Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title_full_unstemmed Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title_short Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
title_sort prediction of new onset of end stage renal disease in chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539616/
https://www.ncbi.nlm.nih.gov/pubmed/28764641
http://dx.doi.org/10.1186/s12882-017-0671-x
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