Lee Changhyun, Yun Hae-Ryong, Joo Young Su, Lee Sangmi, Kim Joohwan, Nam Ki Heon, Jhee Jong Hyun, Park Jung Tak, Yoo Tae-Hyun, Kang Shin-Wook, Han Seung Hyeok
Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea.
Division of Integrated Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kidney Res Clin Pract. 2019 Mar 31;38(1):49-59. doi: 10.23876/j.krcp.18.0118.
Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population.
This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- (< 10%), intermediate- (10-20%), and high- (> 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m).
During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively ( < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197-3.255) and 1.734 (95% CI, 1.447-2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model.
The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.
心血管疾病和慢性肾脏病有若干共同的危险因素。据推测,弗雷明汉风险评分可预测慢性肾脏病的发生。我们确定了弗雷明汉风险评分系统能否正确预测普通人群中慢性肾脏病的发病情况。
本研究纳入了9080名在2001年至2014年间参与韩国基因组与流行病学研究且肾功能正常的受试者。根据基线弗雷明汉风险评分,将受试者分为低风险组(<10%)、中风险组(10%-20%)和高风险组(>20%)。主要终点是慢性肾脏病的发生(估算肾小球滤过率[eGFR]<60 mL/min/1.73 m²)。
在平均8.9±4.3年的随访期内,低风险组、中风险组和高风险组分别有312名(5.3%)、217名(10.8%)和205名(16.9%)受试者发生了慢性肾脏病(P<0.001)。在对混杂因素进行校正后的多变量分析显示,高风险组和中风险组的风险比分别为2.674(95%置信区间[CI],2.197-3.255)和1.734(95%CI,1.447-2.078)。无论是否存在蛋白尿、年龄、性别、肥胖或高血压,均一致观察到这种关联。该评分系统的预测能力低于eGFR和蛋白尿等肾脏参数,但当两者都纳入预测模型时,预测能力有所提高。
弗雷明汉风险评分可预测慢性肾脏病的发病情况,并与传统肾脏参数一起增强了肾功能正常的普通人群的风险分层。