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 the new onset of albuminuria. The authors are from multiple institutions in Europe and Australia.
Patient selection: type 2 diabetes with urine to albumin creatinine ratio < 30 µg/mg
Outcome: new-onset albuminuria (urine albumin to creatinine ratio >= 30 µg/mg)
Parameter:
(1) ethnicity
(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) blood pressure lowering treatment at baseline
(6) hemoglobin A1c in percent
(7) diabetic retinopathy
(8) waist circumferenc in cm
|
Parameter |
Finding |
Points |
|
ethnicity |
Asian |
7 |
|
|
other |
0 |
|
estimated GFR |
>= 90 |
0 |
|
|
75 to 89 |
2 |
|
|
60 to 74 |
3 |
|
|
45 to 59 |
4 |
|
|
< 45 |
5 |
|
UACR ratio |
< 3 |
0 |
|
|
3 to 9 |
8 |
|
|
10 to 29 |
16 |
|
|
>= 30 |
NA |
|
systolic blood pressure |
< 120 |
0 |
|
|
120 to 139 |
1 |
|
|
140 to 159 |
2 |
|
|
160 to 179 |
3 |
|
|
>= 180 |
4 |
|
blood pressure therapy |
no |
0 |
|
|
yes |
3 |
|
hemoglobin A1c |
> 6% |
0 |
|
|
6.0 to 7.9% |
1 |
|
|
8.0 to 9.9% |
2 |
|
|
>= 10% |
3 |
|
diabetic retinopathy |
no |
0 |
|
|
yes |
4 |
|
waist circumference |
< 80 cm |
0 |
|
|
80 to 99 cm |
1 |
|
|
100 to 119 cm |
2 |
|
|
>= 120 cm |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 45
• The higher the score the greater the risk of new-onset albuminuria.
|
Total Score |
5-Year Risk in Percent |
|
0 |
10.3% |
|
1 |
11% |
|
2 |
11.7% |
|
3 |
12.5% |
|
4 |
13.4% |
|
5 |
14.3% |
|
6 |
15.2% |
|
7 |
16.2% |
|
8 |
17.3% |
|
9 |
18.4% |
|
10 |
19.6% |
|
11 |
20.8% |
|
12 |
22.1% |
|
13 |
23.5% |
|
14 |
25% |
|
15 |
26.5% |
|
16 |
28.2% |
|
17 |
29.9% |
|
18 |
31.6% |
|
19 |
33.5% |
|
20 |
35.4% |
|
21 |
37.4% |
|
22 |
39.5% |
|
23 |
41.6% |
|
24 |
43.9% |
|
25 |
46.1% |
|
26 |
48.5% |
|
27 |
50.9% |
|
28 |
53.4% |
|
29 |
55.9% |
|
30 |
58.4% |
|
31 |
60.9% |
|
32 |
63.5% |
|
33 |
66.1% |
|
34 |
68.6% |
|
35 |
71.1% |
|
36 |
73.6% |
|
37 |
76% |
|
38 |
78.2% |
|
39 |
80.6% |
|
40 |
82.8% |
|
41 |
84.8% |
|
42 |
86.8% |
|
43 |
88.6% |
|
44 |
90.2% |
|
45 |
91.7% |
Performance:
• The area under the ROC curve is 0.65.
