From Proteinuria to Albuminuria: Great Expectations for Kidney Failure Risk Prediction

2020 ◽  
Vol 173 (6) ◽  
pp. 492-493
Author(s):  
Tyrone G. Harrison ◽  
Brenda R. Hemmelgarn
Keyword(s):  
Risk Prediction ◽  
Kidney Failure ◽  
Great Expectations ◽  
Failure Risk

MO287REAL WORLD COMPARISON OF THE PREDICTIVE UTILITY OF INTERNATIONAL IGA RISK PREDICTION SCORE AND KIDNEY FAILURE RISK EQUATION IN IGA NEPHROPATHY PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sophia Mohammed ◽  
Rajkumar Chinnadurai ◽  
Arvind Ponnusamy
Keyword(s):  
Iga Nephropathy ◽  
Risk Prediction ◽  
Kidney Failure ◽  
Renal Outcome ◽  
Predictive Utility ◽  
Statistical Validation ◽  
Risk Equation ◽  
Failure Risk ◽  
Stage Renal Disease

Abstract Background and Aims IgA nephropathy is the most prevalent cause of glomerular disease worldwide. The international IgA risk prediction (IgAN) score is a well validated tool to predict the risk of 50% decline in eGFR or end stage renal disease (ESRD) at five years after biopsy in patients with IgA nephropathy. Also, the four variable kidney failure risk equation (KFRE) is another validated tool used to predict the two- and five-year risk of progression to ESRD of all cause chronic kidney disease (CKD 3-5). Our aim is to compare the predictive utility of IgAN score and the KFRE in a real-world cohort of Caucasian patients with long-term follow-up data. Method All available patients with biopsy-proven IgA nephropathy in our centre between January 2001 and December 2013 were included in this observational study. Baseline (biopsy date) data relevant to the scores including demographics, laboratory and the histopathological features were collated at the time of biopsy. Follow up data on renal functions and renal outcome (50% decline in eGFR or reaching ESRD) were collected until an arbitrary end date 31/12/2018. Results We had a total of 115 patients recorded over this 13-year period. The median age of our cohort at time of biopsy was 41 years. Men represented 71% of the cohort. At baseline 84% were hypertensive and 11% diabetic. 77% were on a renin-angiotensin blocker, with 53% being on a statin. Out of the 115 patients, 74 were eligible to undergo analysis. The percentage risk of reaching the endpoint (50% decline in eGFR or reaching ESRD) was calculated at 2 years and 5 years for all patients. These results can be seen in table 1 and 2. At 2 years, 7 patients had reached the endpoint: 2 patients had a >50% decline in eGFR, 3 patients received RRT and 2 patients underwent transplantation. At 5 years, 14 patients had reached the endpoint: 3 patients had a >50% decline in eGFR, 6 patients received RRT and 5 underwent transplantation. Conclusion Our data suggests that the KRFE tool underpredicts the risk of reaching endpoint, compared to the IgAN. Our study has helped to compare the two tools, but further statistical validation is required using a larger cohort.

scholarly journals A validation study of the 4-variable and 8-variable kidney failure risk equation in transplant recipients in the United Kingdom

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ibrahim Ali ◽  
Philip A. Kalra
Keyword(s):  
United Kingdom ◽  
Kidney Failure ◽  
Graft Failure ◽  
Risk Scores ◽  
Transplant Recipients ◽  
Good Discrimination ◽  
Risk Equation ◽  
The United Kingdom ◽  
Failure Risk ◽  
Risk Patients

Abstract Background There is emerging evidence that the 4-variable Kidney Failure Risk Equation (KFRE) can be used for risk prediction of graft failure in transplant recipients. However, geographical validation of the 4-variable KFRE in transplant patients is lacking, as is whether the more extensive 8-variable KFRE improves predictive accuracy. This study aimed to validate the 4- and 8-variable KFRE predictions of the 5-year death-censored risk of graft failure in patients in the United Kingdom. Methods A retrospective cohort study involved 415 transplant recipients who had their first renal transplant between 2003 and 2015 and were under follow-up at Salford Royal NHS Foundation Trust. The KFRE risk scores were calculated on variables taken 1-year post-transplant. The area under the receiver operating characteristic curves (AUC) and calibration plots were evaluated to determine discrimination and calibration of the 4- and 8-variable KFREs in the whole cohort as well as in a subgroup analysis of living and deceased donor recipients and in patients with an eGFR< 45 ml/min/1.73m2. Results There were 16 graft failure events (4%) in the whole cohort. The 4- and 8-variable KFREs showed good discrimination with AUC of 0.743 (95% confidence interval [CI] 0.610–0.876) and 0.751 (95% CI 0.629–0.872) respectively. In patients with an eGFR< 45 ml/min/1.73m2, the 8-variable KFRE had good discrimination with an AUC of 0.785 (95% CI 0.558–0.982) but the 4-variable provided excellent discrimination in this group with an AUC of 0.817 (0.646–0.988). Calibration plots however showed poor calibration with risk scores tending to underestimate risk of graft failure in low-risk patients and overestimate risk in high-risk patients, which was seen in the primary and subgroup analyses. Conclusions Despite adequate discrimination, the 4- and 8-variable KFREs are imprecise in predicting graft failure in transplant recipients using data 1-year post-transplant. Larger, international studies involving diverse patient populations should be considered to corroborate these findings.

scholarly journals External Validation of the Kidney Failure Risk Equation and Re-Calibration with Addition of Ultrasound Parameters

2016 ◽  
Vol 11 (4) ◽  
pp. 609-615 ◽  
Author(s):  
Claudia S. Lennartz ◽  
John William Pickering ◽  
Sarah Seiler-Mußler ◽  
Lucie Bauer ◽  
Kathrin Untersteller ◽  
...  
Keyword(s):  
Kidney Failure ◽  
External Validation ◽  
Risk Equation ◽  
Failure Risk ◽  
Ultrasound Parameters

scholarly journals The Kidney Failure Risk Equation Score and CKD Care Delivery Measures: A Cross-sectional Study

2021 ◽  
Author(s):  
Salman Ahmed ◽  
Suraj Sarvode Mothi ◽  
Thomas Sequist ◽  
Navdeep Tangri ◽  
Roaa M. Khinkar ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risk Equation ◽  
Failure Risk

scholarly journals Use of the Kidney Failure Risk Equation to Determine the Risk of Progression to End-stage Renal Disease in Children With Chronic Kidney Disease

2018 ◽  
Vol 172 (2) ◽  
pp. 174 ◽  
Author(s):  
Erica Winnicki ◽  
Charles E. McCulloch ◽  
Mark M. Mitsnefes ◽  
Susan L. Furth ◽  
Bradley A. Warady ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Failure ◽  
End Stage Renal Disease ◽  
Risk Equation ◽  
Failure Risk ◽  
Risk Of Progression ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Validation of the Kidney Failure Risk Equation in Manitoba

2017 ◽  
Vol 4 ◽  
pp. 205435811770537 ◽  
Author(s):  
Reid H. Whitlock ◽  
Mariette Chartier ◽  
Paul Komenda ◽  
Jay Hingwala ◽  
Claudio Rigatto ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Risk Equation ◽  
Failure Risk
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