A new eight-factor algorithm helps predict which patients are most likely to develop chronic kidney disease (CKD) within a decade. The model is designed for people who have healthy kidneys now but suffer from some other chronic disease.

It is based on data from two population-based cardiovascular studies that created a combined cohort of 14,155 men and women. At baseline, all participants were ≥45 years old (mean 57.6) with an estimated glomerular filtration rate ≥60 mL/min/1.732. Overall, a total of 1,605 people (11.3%) developed CKD over the course of nine years (Arch Intern Med. 2008;168:2466-2473).

“We discovered that a scoring system that included eight key risk factors—older age, anemia, female sex, hypertension, diabetes, peripheral vascular disease (PVD), and any history of heart failure or cardiovascular disease (CVD)—accurately predicted which of the older patients would proceed to CKD,” reports co-author Heejung Bang, PhD, an assistant professor of biostatistics and epidemiology at Weill Cornell Medical College in New York.

The model awards three points for age ≥70 years and one point for each of the other seven factors. Patients who developed CKD tended to be almost five years older than those who did not, white, and more likely to have diabetes, PVD, hypertension, and/or a history of CVD. A score ≥3 captured approximately 70% of incident cases (sensitivity) and accurately predicted a 17% risk of developing CKD (positive predictive value), the researchers report.

“Importantly, we were able to validate the accuracy of the score across different cohorts, suggesting that it remains consistent in a variety of contexts,” notes lead author Abhijit V. Kshirsagar, MD, MPH, of the University of North Carolina Kidney Center at Chapel Hill. “Each of the eight components that make up the score is also easy to identify or quickly assess during a clinician-patient interview.

“Not everyone with a score of ≥3 will develop CKD,” he adds. “They are just at a higher than average risk for kidney disease in the future.” But he recommends that such a score should trigger a conversation encouraging patients to address their sugar intake, BP, and other cardiovascular risks.