Jardine et al reported 2 scores for predicting kidney-related outcomes for a patient with type 2 diabetes. One score predicts major renal event and the second score predicts new onset of albuminuria. The authors are from multiple institutions in Europe and Australia.
Patient selection: type 2 diabetes
Outcome: major renal event (doubling of serum creatinine to >= 2.26 mg/dL, renal replacement or ESRD)
Parameter:
(1) sex
(2) estimated GFR in mL per min per 1.73 square meter
(3) urine albumin to creatinine (UACR) ratio in µg per mg
(4) systolic blood pressure in mm Hg
(5) hemoglobin A1c in percent
(6) diabetic retinopathy
(7) ae at completion of formal education
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
4 |
|
estimated GFR |
>= 90 |
0 |
|
|
75 to 89 |
4 |
|
|
60 to 74 |
7 |
|
|
45 to 59 |
10 |
|
|
< 45 |
13 |
|
UACR ratio |
< 3 |
0 |
|
|
3 to 9 |
2 |
|
|
10 to 29 |
5 |
|
|
30 to 99 |
7 |
|
|
100 to 299 |
9 |
|
|
>= 300 |
11 |
|
systolic blood pressure |
< 120 |
0 |
|
|
120 to 139 |
1 |
|
|
140 to 159 |
2 |
|
|
160 to 179 |
3 |
|
|
>= 180 |
4 |
|
hemoglobin A1c |
> 6% |
0 |
|
|
6.0 to 7.9% |
1 |
|
|
8.0 to 9.9% |
2 |
|
|
>= 10% |
3 |
|
diabetic retinopathy |
no |
0 |
|
|
yes |
2 |
|
age at end formal education |
<= 15 years |
2 |
|
|
>= 16 years |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 39
• The higher the score the greater the risk of a major renal event.
|
Total Score |
5-Year Risk in Percent |
|
0 to 8 |
< 0.1% |
|
9 or 18 |
< 1% |
|
19 |
1% |
|
20 |
1.3% |
|
21 |
1.7% |
|
22 |
2.1% |
|
23 |
2.6% |
|
24 |
3.3% |
|
25 |
4.2% |
|
26 |
5.2% |
|
27 |
6.5% |
|
29 |
8.2% |
|
29 |
10.2% |
|
30 |
12.7% |
|
31 |
15.8% |
|
32 |
19.5% |
|
33 |
23.9% |
|
34 |
29.2% |
|
35 |
35.3% |
|
36 |
42.2% |
|
37 |
50% |
|
38 |
58.3% |
|
39 |
66.8% |
Performance:
• The area under the ROC curve is 0.85.
