Derivation and validation of a renal risk score for people with type 2 diabetes
This could be used as a modelling tool for DHBs and can be accessed here: http://care.diabetesjournals.org/content/36/10/3113.full
Improved risk stratification at baseline may thus help to identify earlier those at increased risk of ESRD as well as aid future research into new interventions to reduce progression. Renal risk models 2, 3, and 4 demonstrated excellent discrimination and calibration in the validation cohort. These models were able to discriminate risk of ESRD events more accurately than using eGFR or albuminuria alone. The choice of model used clinically would depend on the variables available although, where all are available, DCS model 4 is recommended. The models also performed rather better than internationally available renal risk models. This may have been due to the inclusion of ethnic groups relevant to NZ as ethnicity contributed significantly to the models. In 2010, the Ministry of Health established demonstration pilots to test interventions to improve management of chronic kidney disease. The final reports for Christchurch and Northland are available on the HIRC website if you have log-in access or from the Ministry of Health. An article describing the community based Hawkes Bay CKD pilot study is available here: www.renalsociety.org/Resources/Documents/RSAJ/2013.11/walker.pdf
