المفاهيم الأساسية
Development of a prediction tool for hypothyroidism in adults with kidney disease.
الملخص
The study focused on developing and validating a prediction tool for estimating the risk of incident hypothyroidism in adults with moderate-to-advanced chronic kidney disease (CKD). The cohort included 15,642 adults with stage 4-5 CKD, with 10.5% developing incident hypothyroidism during a median 3.4 years follow-up. Factors such as race, baseline TSH levels, and certain medical conditions were associated with the risk of hypothyroidism. The prediction model showed good discrimination, with a C-statistic of 0.77-0.76. The tool aims to improve clinical management by identifying patients who require prioritized screening and treatment.
TOPLINE:
Prediction tool for hypothyroidism in CKD adults.
Cohort of 15,642 adults with stage 4-5 CKD.
10.5% developed incident hypothyroidism.
METHODOLOGY:
Derived prediction model from 10,428 patients.
Internal validation on 5,214 patients.
Incident hypothyroid cases based on TSH levels.
TAKEAWAY:
Factors influencing hypothyroidism risk identified.
Higher TSH levels and amiodarone use linked to increased risk.
Model's discrimination indicated at 76%-77%.
IN PRACTICE:
Tool can aid in clinical management of CKD patients.
Potential for automated analysis in EHR.
SOURCE:
Study conducted by researchers from the University of California, Irvine.
LIMITATIONS:
Model caution for milder kidney dysfunction patients.
Data accuracy crucial for model performance.
Limitations in thyroid autoimmunity measurement.
الإحصائيات
During median 3.4 years follow-up, 1650 (10.5%) of the patients developed incident hypothyroidism.
The model’s discrimination was good, producing similar C-statistics in both the development dataset 0.77, and validation dataset 0.76.
اقتباسات
"The findings have the potential to improve the quality of care of CKD patients."