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Evaluation of the Framingham Heart Study risk factors and risk score for incident chronic kidney disease at 10 years in a Thai general population

  • Nephrology - Original Paper
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Abstract

Purpose

Asians have some of the highest rates of end-stage renal disease, but there is limited information on the risk factors for chronic kidney disease (CKD) in the Asian general population. A risk score for incident CKD for the general population has been developed from the US Framingham Heart Study (FHS) Offspring cohort. This score has been validated on Caucasians and African-Americans, but has not been tested on Asians. We aimed to assess the importance of the FHS risk factors and the performance of the FHS risk score in predicting incident CKD at 10 years in a Thai community-based population.

Methods

This is a prospective study to evaluate the risk factors and the performance of the FHS risk score comprising of age, diabetes, hypertension, proteinuria, and GFR in predicting incident CKD at 10 years in employees (n = 2568) of the Electric Generating Authority of Thailand.

Results

After excluding subjects with CKD at baseline, 10.4% developed incident CKD defined by the MDRD equation and 10.0% by the CKD-EPI equation. Diabetes, hypertension, and baseline GFR were strong predictors of incident CKD, but proteinuria was not. The agreement between the observed rates and the rates predicted by the FHS risk score was not high (MDRD: χ 2 = 30, P < 0.001; CKD-EPI: χ 2 = 256, P < 0.001), and the discrimination of incident CKD was modest (AUROC (95% CI): MDRD, 0.69 (0.66–0.73); CKD-EPI, 0.63 (0.57–0.65).

Conclusions

Although diabetes, hypertension, and baseline GFR were important risk factors, the FHS risk score might not be sufficiently accurate at estimating incident CKD in an Asian general population.

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Acknowledgements

We would like to thank the staff at EGAT and Ramathibodi for clinical and administrative assistance.

Funding

The EGAT study is sponsored by the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, the National Research Council, the Thailand Research Fund, the Thai Heart Association, the Thai Health Foundation, and the Higher Education Research Promotion and National Research University Development, Office of the Higher Education Commission.

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Authors and Affiliations

  1. Cardiovascular and Metabolic Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Krittika Saranburut

  2. Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Prin Vathesatogkit, Piyamitr Sritara & Chagriya Kitiyakara

  3. Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Anchalee Chittamma & Somlak Vanavanan

  4. Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Nisakron Thongmung

  5. Medical and Health Office, Electricity Generating Authority of Thailand, Nonthaburi, Bang kurai, 1130, Thailand

    Tuangrat Tangstheanphan

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  1. Krittika Saranburut
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  2. Prin Vathesatogkit
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Correspondence to Chagriya Kitiyakara.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Saranburut, K., Vathesatogkit, P., Chittamma, A. et al. Evaluation of the Framingham Heart Study risk factors and risk score for incident chronic kidney disease at 10 years in a Thai general population. Int Urol Nephrol 49, 851–857 (2017). https://doi.org/10.1007/s11255-017-1530-1

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  • DOI: https://doi.org/10.1007/s11255-017-1530-1

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