Evaluation of the Framingham Heart Study risk factors and risk score for incident chronic kidney disease at 10 years in a Thai general population.

PURPOSE: Asians have some of the highest rates of end-stage renal disease, but there is limited information on the risk factors for chronic kidney disease (CKD) in the Asian general population. A risk score for incident CKD for the general population has been developed from the US Framingham Heart Study (FHS) Offspring cohort. This score has been validated on Caucasians and African-Americans, but has not been tested on Asians. We aimed to assess the importance of the FHS risk factors and the performance of the FHS risk score in predicting incident CKD at 10 years in a Thai community-based population.

METHODS: This is a prospective study to evaluate the risk factors and the performance of the FHS risk score comprising of age, diabetes, hypertension, proteinuria, and GFR in predicting incident CKD at 10 years in employees (n = 2568) of the Electric Generating Authority of Thailand.

RESULTS: After excluding subjects with CKD at baseline, 10.4% developed incident CKD defined by the MDRD equation and 10.0% by the CKD-EPI equation. Diabetes, hypertension, and baseline GFR were strong predictors of incident CKD, but proteinuria was not. The agreement between the observed rates and the rates predicted by the FHS risk score was not high (MDRD: χ 2  = 30, P < 0.001; CKD-EPI: χ 2  = 256, P < 0.001), and the discrimination of incident CKD was modest (AUROC (95% CI): MDRD, 0.69 (0.66-0.73); CKD-EPI, 0.63 (0.57-0.65).

CONCLUSIONS: Although diabetes, hypertension, and baseline GFR were important risk factors, the FHS risk score might not be sufficiently accurate at estimating incident CKD in an Asian general population.