Predicting the risk of chronic kidney disease in the UK: an evaluation of QKidney® scores using a primary care database

Br J Gen Pract. 2012 Apr;62(597):e243-50. doi: 10.3399/bjgp12X636065.

Abstract

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.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Blood Pressure / physiology
  • Body Mass Index
  • Chronic Disease
  • Creatinine / metabolism
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / physiopathology
  • Kidney Failure, Chronic / epidemiology
  • Male
  • Middle Aged
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Risk Factors
  • Severity of Illness Index
  • Smoking / epidemiology
  • United Kingdom / epidemiology

Substances

  • Creatinine