Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study

Taryn G. Vosters; Vianda S. Stel; Kitty J. Jager; Bart Ferwerda; Roos F. Marsman; Frans J. van Ittersum; Bert-Jan H. van den Born; Henrike Galenkamp; Liffert Vogt; Irene G. M. van Valkengoed

doi:10.1016/j.mayocpiqo.2025.100613

Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study

^*Corresponding author for this work

University of Amsterdam
Amsterdam UMC
Vrije Universiteit Amsterdam

Research output: Contribution to journal › Article › Academic › peer-review

32 Downloads (Pure)

Abstract

Objective: To investigate whether the currently recommended screening criteria in Kidney Disease: Improving Global Outcomes 2024 guidelines (hypertension, diabetes mellitus, and cardiovascular disease) equally detect women and men across ethnic groups and whether consideration of optional criteria (education level, occupation, obesity, and genetic risk factors) listed in the guideline improves performance. Patients and Methods: We included 12,384 women and 9046 men of Dutch, South Asian and African Surinamese, Ghanaian, Turkish, and Moroccan origin from the baseline HELIUS Study (January 1, 2011, through December 31, 2015, Amsterdam, the Netherlands). Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m² or albumin-to-creatinine ratio of >3 mg/mmol. Poisson regression analyses estimated associations between CKD and optional criteria on top of current screening criteria. Model comparisons were made with likelihood ratio tests and Akaike information criterion estimations in women and men. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated by sex and ethnicity. Results: Chronic kidney disease prevalence ranged from 2.9% to 8.8% in women and 3.2% to 8.6% in men. Low educational level (women only) and obesity significantly improved the models with current criteria with CKD. High-risk occupations and polygenic risk score did not improve the model. However, these criteria did not improve predictive measures across ethnic groups. Overall, the AUCs for the current screening criteria were acceptable in men (AUC, 0.75; 95% CI, 0.73-0.77) and poor in women (AUC, 0.65; 95% CI, 0.63-0.67), and showed minimal change after adding the optional criteria. Conclusion: Current screening criteria may not be equally detecting women and men across ethnic groups with CKD. Optional criteria had limited added value.

Original language	English
Article number	100613
Journal	Mayo Clinic proceedings. Innovations, quality & outcomes
Volume	9
Issue number	3
DOIs	https://doi.org/10.1016/j.mayocpiqo.2025.100613
Publication status	Published - 1 Jun 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1016/j.mayocpiqo.2025.100613

Performance-of-current-chronic-kidney-disease-screening-criteria-in-women-and-men-across-ethnic-groups.pdfFinal published version, 572 KBLicence: CC BY

Cite this

Vosters, T. G., Stel, V. S., Jager, K. J., Ferwerda, B., Marsman, R. F., van Ittersum, F. J., van den Born, B.-J. H., Galenkamp, H., Vogt, L., & van Valkengoed, I. G. M. (2025). Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study. Mayo Clinic proceedings. Innovations, quality & outcomes, 9(3), Article 100613. https://doi.org/10.1016/j.mayocpiqo.2025.100613

@article{afeb0d83f1d34477803737d596f23c8e,

title = "Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study",

abstract = "Objective: To investigate whether the currently recommended screening criteria in Kidney Disease: Improving Global Outcomes 2024 guidelines (hypertension, diabetes mellitus, and cardiovascular disease) equally detect women and men across ethnic groups and whether consideration of optional criteria (education level, occupation, obesity, and genetic risk factors) listed in the guideline improves performance. Patients and Methods: We included 12,384 women and 9046 men of Dutch, South Asian and African Surinamese, Ghanaian, Turkish, and Moroccan origin from the baseline HELIUS Study (January 1, 2011, through December 31, 2015, Amsterdam, the Netherlands). Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2 or albumin-to-creatinine ratio of >3 mg/mmol. Poisson regression analyses estimated associations between CKD and optional criteria on top of current screening criteria. Model comparisons were made with likelihood ratio tests and Akaike information criterion estimations in women and men. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated by sex and ethnicity. Results: Chronic kidney disease prevalence ranged from 2.9\% to 8.8\% in women and 3.2\% to 8.6\% in men. Low educational level (women only) and obesity significantly improved the models with current criteria with CKD. High-risk occupations and polygenic risk score did not improve the model. However, these criteria did not improve predictive measures across ethnic groups. Overall, the AUCs for the current screening criteria were acceptable in men (AUC, 0.75; 95\% CI, 0.73-0.77) and poor in women (AUC, 0.65; 95\% CI, 0.63-0.67), and showed minimal change after adding the optional criteria. Conclusion: Current screening criteria may not be equally detecting women and men across ethnic groups with CKD. Optional criteria had limited added value.",

author = "Vosters, \{Taryn G.\} and Stel, \{Vianda S.\} and Jager, \{Kitty J.\} and Bart Ferwerda and Marsman, \{Roos F.\} and \{van Ittersum\}, \{Frans J.\} and \{van den Born\}, \{Bert-Jan H.\} and Henrike Galenkamp and Liffert Vogt and \{van Valkengoed\}, \{Irene G. M.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = jun,

day = "1",

doi = "10.1016/j.mayocpiqo.2025.100613",

language = "English",

volume = "9",

journal = "Mayo Clinic proceedings. Innovations, quality \& outcomes",

issn = "2542-4548",

publisher = "Elsevier B.V.",

number = "3",

}

Vosters, TG , Stel, VS , Jager, KJ , Ferwerda, B , Marsman, RF , van Ittersum, FJ , van den Born, B-JH , Galenkamp, H , Vogt, L & van Valkengoed, IGM 2025, 'Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study', Mayo Clinic proceedings. Innovations, quality & outcomes, vol. 9, no. 3, 100613. https://doi.org/10.1016/j.mayocpiqo.2025.100613

TY - JOUR

T1 - Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups

T2 - The HELIUS Study

AU - Vosters, Taryn G.

AU - Stel, Vianda S.

AU - Jager, Kitty J.

AU - Ferwerda, Bart

AU - Marsman, Roos F.

AU - van Ittersum, Frans J.

AU - van den Born, Bert-Jan H.

AU - Galenkamp, Henrike

AU - Vogt, Liffert

AU - van Valkengoed, Irene G. M.

PY - 2025/6/1

Y1 - 2025/6/1

N2 - Objective: To investigate whether the currently recommended screening criteria in Kidney Disease: Improving Global Outcomes 2024 guidelines (hypertension, diabetes mellitus, and cardiovascular disease) equally detect women and men across ethnic groups and whether consideration of optional criteria (education level, occupation, obesity, and genetic risk factors) listed in the guideline improves performance. Patients and Methods: We included 12,384 women and 9046 men of Dutch, South Asian and African Surinamese, Ghanaian, Turkish, and Moroccan origin from the baseline HELIUS Study (January 1, 2011, through December 31, 2015, Amsterdam, the Netherlands). Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2 or albumin-to-creatinine ratio of >3 mg/mmol. Poisson regression analyses estimated associations between CKD and optional criteria on top of current screening criteria. Model comparisons were made with likelihood ratio tests and Akaike information criterion estimations in women and men. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated by sex and ethnicity. Results: Chronic kidney disease prevalence ranged from 2.9% to 8.8% in women and 3.2% to 8.6% in men. Low educational level (women only) and obesity significantly improved the models with current criteria with CKD. High-risk occupations and polygenic risk score did not improve the model. However, these criteria did not improve predictive measures across ethnic groups. Overall, the AUCs for the current screening criteria were acceptable in men (AUC, 0.75; 95% CI, 0.73-0.77) and poor in women (AUC, 0.65; 95% CI, 0.63-0.67), and showed minimal change after adding the optional criteria. Conclusion: Current screening criteria may not be equally detecting women and men across ethnic groups with CKD. Optional criteria had limited added value.

AB - Objective: To investigate whether the currently recommended screening criteria in Kidney Disease: Improving Global Outcomes 2024 guidelines (hypertension, diabetes mellitus, and cardiovascular disease) equally detect women and men across ethnic groups and whether consideration of optional criteria (education level, occupation, obesity, and genetic risk factors) listed in the guideline improves performance. Patients and Methods: We included 12,384 women and 9046 men of Dutch, South Asian and African Surinamese, Ghanaian, Turkish, and Moroccan origin from the baseline HELIUS Study (January 1, 2011, through December 31, 2015, Amsterdam, the Netherlands). Chronic kidney disease (CKD) was defined as estimated glomerular filtration rate of <60 mL/min/1.73 m2 or albumin-to-creatinine ratio of >3 mg/mmol. Poisson regression analyses estimated associations between CKD and optional criteria on top of current screening criteria. Model comparisons were made with likelihood ratio tests and Akaike information criterion estimations in women and men. Area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values were calculated by sex and ethnicity. Results: Chronic kidney disease prevalence ranged from 2.9% to 8.8% in women and 3.2% to 8.6% in men. Low educational level (women only) and obesity significantly improved the models with current criteria with CKD. High-risk occupations and polygenic risk score did not improve the model. However, these criteria did not improve predictive measures across ethnic groups. Overall, the AUCs for the current screening criteria were acceptable in men (AUC, 0.75; 95% CI, 0.73-0.77) and poor in women (AUC, 0.65; 95% CI, 0.63-0.67), and showed minimal change after adding the optional criteria. Conclusion: Current screening criteria may not be equally detecting women and men across ethnic groups with CKD. Optional criteria had limited added value.

UR - https://www.scopus.com/pages/publications/105002672218

U2 - 10.1016/j.mayocpiqo.2025.100613

DO - 10.1016/j.mayocpiqo.2025.100613

M3 - Article

C2 - 40290568

SN - 2542-4548

VL - 9

JO - Mayo Clinic proceedings. Innovations, quality & outcomes

JF - Mayo Clinic proceedings. Innovations, quality & outcomes

IS - 3

M1 - 100613

ER -

Performance of Current Chronic Kidney Disease Screening Criteria in Women and Men Across Ethnic Groups: The HELIUS Study

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this