{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:04:09Z","timestamp":1790251449987,"version":"4.1.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>End-stage kidney disease (ESKD) is a life-threatening complication of diabetes that can be prevented or delayed by intervention. Hence, early detection of people at increased risk is essential.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>From a population-based cohort of 5,460 clinically diagnosed Danish adults with type 1 diabetes followed from 2001 to 2016, we developed a prediction model for ESKD accounting for the competing risk of death. Poisson regression analysis was used to estimate the model on the basis of information routinely collected from clinical examinations. The effect of including an extended set of predictors (lipids, alcohol intake, etc.) was further evaluated, and potential interactions identified in a survival tree analysis were tested. The final model was externally validated in 9,175 adults from Denmark and Scotland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>During a median follow-up of 10.4 years (interquartile limits 5.1; 14.7), 303 (5.5%) of the participants (mean [SD] age 42.3 [16.5] years) developed ESKD, and 764 (14.0%) died without having developed ESKD. The final ESKD prediction model included age, male sex, diabetes duration, estimated glomerular filtration rate, micro- and macroalbuminuria, systolic blood pressure, hemoglobin A1c, smoking, and previous cardiovascular disease. Discrimination was excellent for 5-year risk of an ESKD event, with a C-statistic of 0.888 (95% CI 0.849; 0.927) in the derivation cohort and confirmed at 0.865 (0.811; 0.919) and 0.961 (0.940; 0.981) in the external validation cohorts from Denmark and Scotland, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>We have derived and validated a novel, high-performing ESKD prediction model for risk stratification in the adult type 1 diabetes population. This model may improve clinical decision making and potentially guide early intervention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc20-2586","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T17:24:36Z","timestamp":1611854676000},"page":"901-907","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":29,"title":["A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes"],"prefix":"10.2337","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5045-5351","authenticated-orcid":false,"given":"Dorte","family":"Vistisen","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregers S.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Hulman","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart J.","family":"McGurnaghan","sequence":"additional","affiliation":[{"name":"University of Edinburgh, Edinburgh, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-3288","authenticated-orcid":false,"given":"Helen M.","family":"Colhoun","sequence":"additional","affiliation":[{"name":"University of Edinburgh, Edinburgh, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan E.","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Odense, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-3474","authenticated-orcid":false,"given":"Reimar W.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederik","family":"Persson","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark"},{"name":"University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8356-5565","authenticated-orcid":false,"given":"Marit E.","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Gentofte, Denmark"},{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"2022031309474588300_B1","unstructured":"Steno Diabetes Center Copenhagen\n          . Diabetes demography, cardiometabolic risk factors, and acute- and chronic diabetes complications in a nationwide diabetes registry in Denmark: a retrospective nationwide cohort study to investigate diabetes related complications and mortality rates over time, 2020. Accessed 14 August 2020. Available from https:\/\/www.sdcc.dk\/forskning\/forskningsaktivitet\/Documents\/Diabetes%20demography%20report.pdf"},{"key":"2022031309474588300_B2","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1007\/s00125-019-05052-z","article-title":"Predicting renal disease progression in a large contemporary cohort with type 1 diabetes mellitus","volume":"63","author":"Colombo","year":"2020","journal-title":"Diabetologia"},{"key":"2022031309474588300_B3","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2337\/dc17-2364","article-title":"Incidence of end-stage renal disease in patients with type 1 diabetes","volume":"41","author":"Helve","year":"2018","journal-title":"Diabetes Care"},{"key":"2022031309474588300_B4","doi-asserted-by":"crossref","first-page":"381","DOI":"10.2337\/dc13-1287","article-title":"Risk for end-stage renal disease over 25 years in the population-based WESDR cohort","volume":"37","author":"Lecaire","year":"2014","journal-title":"Diabetes Care"},{"key":"2022031309474588300_B5","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1056\/NEJMoa1310799","article-title":"Changes in diabetes-related complications in the United States, 1990-2010","volume":"370","author":"Gregg","year":"2014","journal-title":"N Engl J Med"},{"key":"2022031309474588300_B6","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s00125-019-4812-6","article-title":"Effect of duration and burden of microvascular complications on mortality rate in type 1 diabetes: an observational clinical cohort study","volume":"62","author":"Bjerg","year":"2019","journal-title":"Diabetologia"},{"key":"2022031309474588300_B7","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1038\/ki.1995.236","article-title":"Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial","volume":"47","author":"The Diabetes Control and Complications Research Group","year":"1995","journal-title":"Kidney Int"},{"key":"2022031309474588300_B8","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1093\/ije\/dyr213","article-title":"Competing risks in epidemiology: possibilities and pitfalls","volume":"41","author":"Andersen","year":"2012","journal-title":"Int J Epidemiol"},{"key":"2022031309474588300_B9","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1111\/j.1532-5415.2010.02767.x","article-title":"Competing risk of death: an important consideration in studies of older adults","volume":"58","author":"Berry","year":"2010","journal-title":"J Am Geriatr Soc"},{"key":"2022031309474588300_B10","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1007\/s00125-014-3358-x","article-title":"Predicting major outcomes in type 1 diabetes: a model development and validation study","volume":"57","author":"Soedamah-Muthu","year":"2014","journal-title":"Diabetologia"},{"key":"2022031309474588300_B11","doi-asserted-by":"crossref","first-page":"3113","DOI":"10.2337\/dc13-0190","article-title":"Derivation and validation of a renal risk score for people with type 2 diabetes","volume":"36","author":"Elley","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031309474588300_B12","doi-asserted-by":"crossref","first-page":"10177","DOI":"10.1038\/s41598-017-09243-9","article-title":"Development and validation of a risk prediction model for end-stage renal disease in patients with type 2 diabetes","volume":"7","author":"Lin","year":"2017","journal-title":"Sci Rep"},{"key":"2022031309474588300_B13","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1186\/s12882-017-0671-x","article-title":"Prediction of new onset of end stage renal disease in Chinese patients with type 2 diabetes mellitus - a population-based retrospective cohort study","volume":"18","author":"Wan","year":"2017","journal-title":"BMC Nephrol"},{"key":"2022031309474588300_B14","first-page":"1832","article-title":"Risk factors for renal dysfunction in type 2 Diabetes: U.K. Prospective Diabetes Study 74","author":"Retnakaran","year":"2006"},{"key":"2022031309474588300_B15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2337\/dc18-1369","article-title":"Variations in risk of end-stage renal disease and risk of mortality in an international study of patients with type 1 diabetes and advanced nephropathy","volume":"42","author":"Skupien","year":"2019","journal-title":"Diabetes Care"},{"key":"2022031309474588300_B16","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.kint.2020.06.019","article-title":"KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease","volume":"98","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group","year":"2020","journal-title":"Kidney Int"},{"key":"2022031309474588300_B17","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/1403494811399958","article-title":"The Danish register of causes of death","volume":"39","author":"Helweg-Larsen","year":"2011","journal-title":"Scand J Public Health"},{"key":"2022031309474588300_B18","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/1403494811401482","article-title":"The Danish National Patient Register","volume":"39","author":"Lynge","year":"2011","journal-title":"Scand J Public Health"},{"key":"2022031309474588300_B19","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/978-3-319-17145-6_6","article-title":"The creation of the central person registry in Denmark","volume-title":"History of Nordic Computing 4: 4th IFIP WG 9.7 Conference, HiNC4, Copenhagen, Denmark, August 13\u201315, 2014, Revised Selected Papers (IFIP Advances in Information and Communication Technology (447))","author":"Ebbesen","year":"2015"},{"key":"2022031309474588300_B20","unstructured":"Regionernes Kliniske Kvalitetsudviklingsprogram\n          . Dansk Voksen Diabetes Database: datadefinitioner, 2019. Accessed 24 August 2020. Available from http:\/\/test4.rm.dk\/siteassets\/om-rkkp\/de-kliniske-kvalitetsdatabaser\/voksendiabetes\/dvdd_datadefinitioner_december2019.pdf"},{"key":"2022031309474588300_B21","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.2337\/dc19-0349","article-title":"Progressive decline in estimated glomerular filtration rate in patients with diabetes after moderate loss in kidney function-even without albuminuria","volume":"42","author":"Vistisen","year":"2019","journal-title":"Diabetes Care"},{"key":"2022031309474588300_B22","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1161\/CIRCULATIONAHA.115.018844","article-title":"Prediction of first cardiovascular disease event in type 1 diabetes mellitus: the Steno Type 1 Risk Engine","volume":"133","author":"Vistisen","year":"2016","journal-title":"Circulation"},{"key":"2022031309474588300_B23","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"2022031309474588300_B24","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1198\/106186006X133933","article-title":"Unbiased recursive partitioning: a conditional inference framework","volume":"15","author":"Hothorn","year":"2006","journal-title":"J Comput Graph Stat"},{"key":"2022031309474588300_B25","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1002\/sim.3058","article-title":"Age\u2013period\u2013cohort models for the Lexis diagram, Statistics in Medicine 2007; 26:3018\u20133045","volume":"27","author":"Carstensen","year":"2008","journal-title":"Stat Med"},{"key":"2022031309474588300_B26","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1002\/sim.4780122407","article-title":"Cross-validation in survival analysis","volume":"12","author":"Verweij","year":"1993","journal-title":"Stat Med"},{"key":"2022031309474588300_B27","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/clinchem\/39.4.561","article-title":"Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine","volume":"39","author":"Zweig","year":"1993","journal-title":"Clin Chem"},{"key":"2022031309474588300_B28","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4899-4541-9","volume-title":"An Introduction to the Bootstrap","author":"Efron","year":"1993"},{"key":"2022031309474588300_B29","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/biostatistics\/kxi005","article-title":"On criteria for evaluating models of absolute risk","volume":"6","author":"Gail","year":"2005","journal-title":"Biostatistics"},{"key":"2022031309474588300_B30","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jclinepi.2009.12.008","article-title":"Missing covariate data in medical research: to impute is better than to ignore","volume":"63","author":"Janssen","year":"2010","journal-title":"J Clin Epidemiol"},{"key":"2022031309474588300_B31","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0962280206074463","article-title":"Multiple imputation of discrete and continuous data by fully conditional specification","volume":"16","author":"van Buuren","year":"2007","journal-title":"Stat Methods Med Res"},{"key":"2022031309474588300_B32","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1471-2288-9-57","article-title":"Combining estimates of interest in prognostic modelling studies after multiple imputation: current practice and guidelines","volume":"9","author":"Marshall","year":"2009","journal-title":"BMC Med Res Methodol"},{"key":"2022031309474588300_B33","doi-asserted-by":"crossref","first-page":"e035492","DOI":"10.1136\/bmjopen-2019-035492","article-title":"Cohort profile: the Funen Diabetes Database-a population-based cohort of patients with diabetes in Denmark","volume":"10","author":"Adelborg","year":"2020","journal-title":"BMJ Open"},{"key":"2022031309474588300_B34","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.2337\/db09-1744","article-title":"Cumulative risk, age at onset, and sex-specific differences for developing end-stage renal disease in young patients with type 1 diabetes: a nationwide population-based cohort study","volume":"59","author":"M\u00f6llsten","year":"2010","journal-title":"Diabetes"},{"key":"2022031309474588300_B35","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/ki.2014.206","article-title":"Improved prognosis of diabetic nephropathy in type 1 diabetes","volume":"87","author":"Andr\u00e9sd\u00f3ttir","year":"2015","journal-title":"Kidney Int"},{"key":"2022031309474588300_B36","doi-asserted-by":"crossref","first-page":"e0216559","DOI":"10.1371\/journal.pone.0216559","article-title":"Predicting kidney failure from longitudinal kidney function trajectory: a comparison of models","volume":"14","author":"van den Brand","year":"2019","journal-title":"PLoS One"},{"key":"2022031309474588300_B37","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1007\/s00125-018-4567-5","article-title":"Biomarkers of diabetic kidney disease","volume":"61","author":"Colhoun","year":"2018","journal-title":"Diabetologia"},{"key":"2022031309474588300_B38","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1007\/s00125-019-4915-0","article-title":"Biomarker panels associated with progression of renal disease in type 1 diabetes","volume":"62","author":"Colombo","year":"2019","journal-title":"Diabetologia"},{"key":"2022031309474588300_B39","doi-asserted-by":"crossref","first-page":"e001071","DOI":"10.1136\/bmjdrc-2019-001071","article-title":"Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996-2016","volume":"8","author":"Carstensen","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2022031309474588300_B40","unstructured":"Dansk Diabetes Database\n          . National \u00e5rsrapport 2017\/2018. Accessed 27 August 2020. Available from https:\/\/www.sundhed.dk\/content\/cms\/87\/4687_diabetes_2017_18_offentliggoerelse_v2.pdf"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/44\/4\/901\/632162\/dc202586.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/44\/4\/901\/632162\/dc202586.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T10:53:31Z","timestamp":1647168811000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/44\/4\/901\/138616\/A-Validated-Prediction-Model-for-End-Stage-Kidney"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,1,28]]},"published-print":{"date-parts":[[2021,4,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc20-2586","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,28]]}}}