Abstract
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Abstract
Year 2021
October 2021

SHBC1196

Abstract Title
RISK PREDICTION EQUATION FOR INCIDENT CHRONIC KIDNEY DISEASE (CKD) IN A HYPERTENSIVE NON- DIABETIC SINGAPOREAN COHORT
Authors

W.WENG1, S.Y.WONG1, Y.ANG2, H.X.NG2, C.K.LIM3, S.C.YEO1 

Institutions

Tan Tock Seng Hospital1, NHGHQ2, NHG Polyclinics3 

Background & Hypothesis

Accurate identification of individuals at risk of developing CKD may improve clinical care and delay progression. 2 risk prediction equations (Nelson, 2019) used to estimate the risk of incident estimated glomerular filtration rate (eGFR)<60 ml/min/1.73m2 in diabetic and non-diabetic patients have not been validated locally. We aim to validate the non-diabetic equation in our local population and develop further prediction models.

Methods

Demographics, clinical and laboratory data of hypertensive non–diabetic patients with baseline eGFR ≥60ml/min/1.73m2 who were on follow up with NHG polyclinics between 2010 to 2015 were collected. 5-year risk of incident eGFR<60ml/min/1.73m2 was predicted using the non-diabetic equation. Variables included age, sex, race, eGFR, history of cardiovascular disease(CVD), ever smoker, BMI and albuminuria. Models employed Cox proportional hazard regression and were evaluated by the Harrell C-statistic.

Results

35,043 patients were included in the study. 49.1% were female and mean age was 58.0 years. Baseline mean eGFR was 90.8ml/min/1.73m2. 3461 (9.9%) patients developed eGFR<60ml/min/1.73m2. Older age, lower baseline eGFR, male gender, history of CVD, ever smoker, elevated BMI were risk factors for eGFR<60ml/min/1.73m2. Applicability of the existing equation was limited by missing albuminuria, absence of black race and exclusion of non-hypertensive patients in our cohort. Nonetheless, the model without the 3 variables demonstrated C-statistic of 0.85 (95%CI:0.85-0.86). Novel models including race, blood pressure and history of heart failure demonstrated similar results.

Discussion & Conclusion

The adapted risk prediction equations demonstrate similar high discrimination in our population, despite utilising fewer variables. They have potential clinical applicability and should be validated in a future cohort.

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