Johnson et al developed a model that can help to identify a patient with chronic kidney disease who may experience disease progression within the next 5 years. This can help to identify a patient who may benefit from more aggressive management. The authors are from Kaiser Permanente Northwest and McGill University.
Patient selection: chronic kidney disease, estimated creatinine clearance < 60 mL per minute per 1.73 square meters, age 30 to 89 years
Outcome: need for renal replacement therapy (dialysis or transplant) within the next 5 years
Parameters:
(2) estimated GFR in mL per minute per 1.73 square meters
(3) gender
(4) diabetes
(5) hypertension
(6) anemia
|
Parameter |
Finding |
Points |
|
age in years |
30 to 34 years |
64 |
|
|
35 to 39 |
62 |
|
|
40 to 44 |
60 |
|
|
45 to 49 |
58 |
|
|
50 to 54 |
56 |
|
|
55 to 59 |
54 |
|
|
60 to 64 |
51 |
|
|
65 to 69 |
46 |
|
|
70 to 74 |
41 |
|
|
75 to 79 |
34 |
|
|
80 to 84 |
19 |
|
|
85 to 89 |
0 |
|
eGFR |
55 to 59 mL per min per 1.73 square meters |
0 |
|
|
50 to 54 |
15 |
|
|
45 to 49 |
17 |
|
|
40 to 44 |
22 |
|
|
35 to 39 |
32 |
|
|
30 to 34 |
44 |
|
|
25 to 29 |
58 |
|
|
20 to 24 |
72 |
|
|
15 to 19 |
86 |
|
gender |
female |
0 |
|
|
male |
16 |
|
diabetes |
absent |
0 |
|
|
present |
17 |
|
hypertension |
absent |
0 |
|
|
present |
42 |
|
anemia |
absent |
0 |
|
|
present |
11 |
total score -
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 236
• The higher the score the greater the risk of progression.
|
Total Score |
5-Year Risk |
|
98 |
>= 1% |
|
131 |
>= 5% |
|
146 |
>= 10% |
|
159 |
>= 15% |
|
165 |
>= 20% |
Performance:
• The area under the ROC curve was 0.89.
Purpose: To evaluate a patient with chronic kidney disease for 5-year risk of disease progression using the model of Johnson et al.
Specialty: Neurology, Emergency Medicine
Objective: risk factors, disease progression
ICD-10: N17-N19,
