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Submitted: 30 Dec 2018
Accepted: 14 Feb 2019
First published online: 08 Mar 2019
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J Nephropharmacol. 2019;8(2): e20.
doi: 10.15171/npj.2019.20
  Abstract View: 350
  PDF Download: 336

Original

Statistical significance of prognostic factors on the progression of chronic kidney disease through simulation study

Alka Sabharwal 1, Gurprit Grover 2, Shrawan Kumar 1 *

1 Department of Statistics, Kirori Mal College, University of Delhi, Delhi, India
2 Department of Statistics, University of Delhi, Delhi, India
*Corresponding author: Shrawan Kumar, Email; Email: shrawan.kmc@gmail.com

Abstract

Introduction: Chronic kidney disease (CKD) is a serious public health problem. It affects 10% to 16% of adults around the world. In India, the approximate prevalence is 800 per million population (pmp) and incidence of end-stage renal disease (ESRD) is 150 -200 pmp.

Objectives: To evaluate the differences in the impact of prognostic factors for the progression of CKD into higher stages using appropriate and robust tests.

Materials and Methods: Permutation test and likelihood ratio test were applied to ascertain the statistical significance of the prognostic factors for the progression of CKD into higher stages. The data consists of 100 non-hospitalized CKD patients of three stages namely stage 2, stage 3 and stage 4. A simulation study has been carried out to determine the power of permutation test and likelihood ratio test testing the significance of difference between the values of the parameters of the distribution of prognostic factors involved in the progression of CKD in stage 2, stage 3 and stage 4.

Results: Permutation test and likelihood ratio test based on our data set suggest that serum creatinine, urea, hemoglobin, albumin and age are the significant factors for the progression of CKD to higher stages.

Conclusion: Under various health conditions using simulation study, all the factors included in the study are responsible for the progression of the disease.

Keywords: Chronic kidney disease, Likelihood ratio test, Permutation test, Simulation, End-stage renal disease

Implication for health policy/practice/research/medical education:

The present work helps in identifying the risk factors of CKD. It will help in implementing screening of at-risk populations which in turn will increase the early detection, initiate treatment of modifiable risk factors for ESRD, along with appropriate treatment of chronic kidney disease. The economic burden caused by the cost of renal replacement therapy /kidney transplant might be reduced by early detection of risk factors.

Please cite this paper as: Sabharwal A, Grover G, Kumar S. Statistical significance of prognostic factors on the progression of chronic kidney disease through simulation study. J Nephropharmacol. 2019;8(2):e20. DOI: 10.15171/npj.2019.20.

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