Development of Risk Prediction Equations for Incident Chronic Kidney Disease

Nelson, Robert G.; Grams, Morgan E.; Ballew, Shoshana H.; Sang, Yingying; Azizi, Fereidoun; Chadban, Steven J.; Chaker, Layal; Dunning, Stephan; Fox, Caroline S.; Hirakawa, Yoshihisa; Iseki, Kunitoshi; Ix, Joachim H.; Jafar, Tazeen H.; Köttgen, Anna; Naimark, David; Ohkubo, Takayoshi; Prescott, Gordon; Rebholz, Casey M.; Sabanayagam, Charumathi; Sairenchi, Toshimi; Schöttker, Ben; Shibagaki, Yugo; Tonelli, Marcello; Zhang, Luxia; Gansevoort, Ron T.; Matsushita, Kunihiro; Woodward, Mark; Shalev, Varda

doi:10.1001/jama.2019.17379

Cited by 159 publications

(211 citation statements)

References 44 publications

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“…The findings of the current study about the association of parity number with incident CVD among women are consistent with a meta-analysis study on this issue by Li et al [8]. in which they found a non-linear J-shaped dose-response relationship between the number of parity and CVD among women.…”

Section: Discussionsupporting

confidence: 92%

“…They also found that each live birth was associated with a 1% non-significant increased risk for CVD mortality (I 2 = 86.4%). It should be noted that the significant heterogeneity in these two meta-analyses [8,20] could be related to different study populations, sample sizes and other epidemiologic aspects of studies.…”

Section: Discussionmentioning

confidence: 99%

“…While these kinds of changes are considered as normal physiological change, which are beneficial to both mother and fetus, they can also increase the prevalence of potential risk factors for CVD. Additional stressors such as endothelial dysfunction, inflammation and hemostasis process during pregnancy may exacerbate this situation [6][7][8]. Results of previous studies on the association of parity (i.e., number of pregnancies reaching viable gestational age) and gravity (i.e., number of times a woman is or has been pregnant, regardless of the pregnancy outcome) with the risk of CVD are inconsistent and controversial [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Additional stressors such as endothelial dysfunction, inflammation and hemostasis process during pregnancy may exacerbate this situation [6][7][8]. Results of previous studies on the association of parity (i.e., number of pregnancies reaching viable gestational age) and gravity (i.e., number of times a woman is or has been pregnant, regardless of the pregnancy outcome) with the risk of CVD are inconsistent and controversial [8,9]. Peters et al showed that among 10 European countries, parous women had a 19% higher risk of CHD than nulliparous women; with this risk reaching up to 95% among women who had ≥ 5 children [9].…”

Section: Introductionmentioning

confidence: 99%

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Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

Moazzeni¹,

Toreyhi²,

Asgari³

et al. 2020

Preprint

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Background Most previous studies, conducted in non-Middle Eastern populations, have suggested that increase in the number of parity/live birth(s) leads to cardiovascular disease (CVD) development, although this issue is still controversial among both sexes. Biologic and socioeconomic pathways were suggested to explain this association. We studied this issue among urban Iranian men and women. Methods In this population-based cohort study, included 3929 women and 2571 men aged ≥ 30 years, Data for number of parity/live birth(s) were obtained by standard questionnaire. Participants were then annually followed for CVD events. Multivariate Cox proportional hazard models were used to estimate hazard ratios (HRs), and 95% confidence intervals (CIs) for the number of parity/live birth(s) and other traditional CVD risk factors. Results During more than 15 years of follow-up, 456 and 524 CVD events have occurred among women and men, respectively. Among women, a J-shaped association was found between the number of live births and incident CVD with the lowest risk for women with 2 live births. Among women in multivariate analyses, each unit increase in parity had a HR of 1.05 (CI: 1.01–1.10) and having ≥ 4 parities was associated with a HR of 1.86 (0.97–3.56, p-value = 0.061). Among men, in comparison with participants who had 1 child, multivariate HRs of having 2, 3 and ≥ 4 children were 1.97 (1.24–3.12), 2.08 (1.31–3.31) and 2.08 (1.30–3.34), respectively. Conclusion To the best of our knowledge, the current study is the first report of this issue in the Middle East and North Africa region, a region with high burden of CVD. It can now be suggested that the number of parity/live birth(s) is linked to CVD among the Iranian population, with this issue being more prominent among men. Further research is needed to support our results and clarify the pathways between the number of parity/live birth(s) and CVD development among Iranian populations by considering potential factors, especially psycho-socio-economic factors.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

Moazzeni¹,

Toreyhi²,

Asgari³

et al. 2020

Preprint

Self Cite

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“…Diabetes is a risk factor for both CKD and CVD (3,4,8). To date, various models have been proposed for the prediction of T2DM (9,10), CKD (11), and CVD (10,(12)(13)(14)(15) separately. Most of the previous models were comprised of non-laboratory measures.…”

Section: Introductionmentioning

confidence: 99%

External validation of the European risk assessment tool for Chronic Cardio-metabolic disorders in a Middle Eastern population

Asgari

Moosaie

Khalili

et al. 2020

Preprint

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Abstract Background: High burden of chronic cardio-metabolic disorders including type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD) have been reported in the Middle East and North Africa region. We aimed to externally validate a non-laboratory risk assessment tool for the prediction of the chronic cardio-metabolic disorders in the Iranian population. Methods: The predictors included age, body mass index, waist circumference, use of antihypertensive, current smoking, and family history of cardiovascular disease and/or diabetes. For external validation of the model in the Tehran lipids and glucose study (TLGS), the Area under the curve (AUC) and the Hosmer-Lemeshow (HL) goodness of fit test were performed for discrimination and calibration, respectively. Results: Among 1310 men and 1960 women aged 28-85 years, 29.5% and 47.4% experienced chronic cardio-metabolic disorders during the 6 and 9-year follow-up, respectively. The model showed acceptable discrimination, with an AUC of 0.72(95% CI: 0.69-0.75) for men and 0.73(95% CI: 0.71-0.76) for women. The calibration of the model was good for both genders (min HL P=0.5). Considering separate outcomes, AUC was highest for CKD (0.76(95% CI: 0.72-0.79)) and lowest for T2DM (0.65(95% CI: 0.61-0.69)), in men. As for women, AUC was highest for CVD (0.82(95% CI: 0.78-0.86)) and lowest for T2DM (0.69(95% CI: 0.66-0.73)). The 9-year follow-up demonstrated almost similar performances compared to the 6-year follow-up. Using Cox regression in place of logistic multivariable analysis, model’s discrimination and calibration were reduced for prediction of chronic cardio-metabolic disorders; the issue which had more effect on the prediction of incident CKD among women. Moreover, adding data of educational levels and marital status did not improve, the discrimination and calibration in the enhanced model.Conclusion: This model showed acceptable discrimination and good calibration for risk prediction of chronic cardio-metabolic disorders in short and long-term follow-up in the Iranian population.

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Predicting Risk of Kidney Disease

Tummalapalli

Estrella

2019

JAMA

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Development of Risk Prediction Equations for Incident Chronic Kidney Disease

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Cited by 159 publications

References 44 publications

Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

Number of parity/live birth(s) and cardiovascular disease among Iranian women and men: Results of over 15 years of follow-up.

External validation of the European risk assessment tool for Chronic Cardio-metabolic disorders in a Middle Eastern population

Predicting Risk of Kidney Disease

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