The clinical characteristics needed for prediction--for example, to develop a population-based, prognostic risk score--were often documented during routine care years before patients developed ESRD and required RRT. Nephrologists have long recognized the prognostic value of many of the patient characteristics used in this case-control study. What's important for intervention in primary care is that most of the characteristics are readily available through patient history and the outpatient medical record. Future studies should develop prognostic risk scores to predict the absolute risk of developing ESRD and starting RRT, which will require a more systemic collection of laboratory findings for eGFR and proteinuria.
Sanofi-Aventis sponsored the study through a contract to Kaiser Permanente's Center for Health Research. The contract protected the investigators' right to publish the findings in the journal of their choice and the Kaiser Permanente investigators were under no obligation to accept the sponsor's comments on the manuscript, which does not evaluate any products. All authors were employees of Kaiser Permanente except Dr Juhaeri Juhaeri who was employed by Sanofi-Aventis at the time the study was conducted. Dr Juhaeri was involved in the study's conceptualization and provided critical revisions to the manuscript, but Dr Juhaeri, as a representative of the sponsor, had no role in deciding whether to submit the manuscript for publication. Dr Eric Johnson wrote the manuscript without the assistance of medical writers. We wish to thank Ms Mara Kalter and Ms Amanda Petrik for their support in coordinating the study.
EJ, DS, MT and JJ conceptualized the study and its objective. EJ and DS designed the study. MT confirmed cases of RRT by reviewing medical records. DS and MT provided clinical expertise on measuring and selecting the baseline predictor characteristics. XY extracted the data from the HMO's databases, analyzed the data statistically and contributed to the data's interpretation. EJ wrote the manuscript; DS, MT, XY and JJ revised the manuscript critically. All authors read and approved the manuscript.
The authors have no competing financial interest to declare because the study evaluates the natural history of chronic kidney disease and does not evaluate any products.
BMC Nephrology. 2011;11 © 2011 BioMed Central, Ltd.
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Cite this: Predicting the Risk of End-stage Renal Disease in the Population-based Setting - Medscape - May 01, 2011.