A Simple Tool to Predict End‐Stage Renal Disease within 1 Year in Elderly Adults with Advanced Chronic Kidney Disease. Issue 5 (25th April 2013)

• Record Type: Journal Article
• Authors: Drawz, Paul E.; Goswami, Puja; Azem, Reem; Babineau, Denise C.; Rahman, Mahboob
• Is Part Of: Journal of the American Geriatrics Society. Volume 61:Issue 5(2013:May)
• Page Start: 762
• Page End: 768
• Publication Date: 2013-04-25
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.12223
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs12223-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs12223-sec-0001" sec-type="section"> <title>Objectives</title> <p>To develop and validate a model to predict 1‐year risk of end‐stage renal disease (ESRD) in elderly subjects with advanced chronic kidney disease (CKD).</p> </sec> <sec id="jgs12223-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective.</p> </sec> <sec id="jgs12223-sec-0003" sec-type="section"> <title>Setting</title> <p>Veterans Affairs Medical Center.</p> </sec> <sec id="jgs12223-sec-0004" sec-type="section"> <title>Participants</title> <p>Individuals aged 65 and older with CKD with an estimated glomerular filtration rate (eGFR) less than 30 mL/min per 1.73 m<sup>2</sup>.</p> </sec> <sec id="jgs12223-sec-0005" sec-type="section"> <title>Measurements</title> <p>The outcome was ESRD within 1 year of the index eGFR. Cox regression was used to develop a predictive model (Veterans Affairs (VA) risk score) that was validated in a separate cohort.</p> </sec> <sec id="jgs12223-sec-0006" sec-type="section"> <title>Results</title> <p>Of the 1, 866 participants in the developmental cohort, 77 developed ESRD. Risk factors for ESRD in the final model were age, congestive heart failure, systolic blood pressure, eGFR, potassium, and albumin. In the validation cohort, the C index for the VA risk score was 0.823. The risk for developing ESRD at 1 year from lowest to highest tertile was 0.08%, 2.7%, and 11.3% (<italic>P</italic> < .001). The C‐index for the recently published Tangri model in the validation cohort was 0.780.</p> </sec> <sec id="jgs12223-sec-0007" sec-type="section"> <title>Conclusion</title> <p>A new model using commonly available clinical measures shows excellent ability to predict the onset of ESRD within the next year in elderly adults. The Tangri model also had good predictive ability. Individuals and physicians can use these risk models to inform decisions regarding preparation for renal replacement therapy in individuals with advanced CKD.</p> </sec> </abstract>