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

Clinical Journal of the American Society of Nephrology : CJASN
Claudia S LennartzGunnar H Heine

Abstract

Progression of CKD toward ESRD is heterogeneous. The Kidney Failure Risk Equation (KFRE) was developed to identify CKD patients at high risk of ESRD. We aimed to externally validate KFRE and to test whether the addition of predefined Duplex ultrasound markers - renal resistive index (RRI) or difference of resistive indices in spleen and kidney (DI-RISK) - improved ESRD prediction. The prospective Cardiovascular and Renal Outcome in CKD 2-4 Patients-The Fourth Homburg evaluation (CARE FOR HOMe) study recruits CKD stage G2-G4 patients referred to a tertiary referral center for nephrologic care. Four hundred three CARE FOR HOMe participants enrolled between 2008 and 2012 had available RRI measurements at study inclusion; they were subsequently followed for a mean of 4.4±1.6 years. This subcohort was used to validate KFRE and to assess the added value of the ultrasound markers (new models KFRE+RRI and KFRE+DI-RISK). Model performance was assessed by log-likelihood ratio test, c-statistic, integrated discrimination improvement metrics (for study participants without subsequent ESRD [IDI No ESRD] and for patients with ESRD [IDI ESRD]), and calibration plots. If either new model improved on KFRE, we determined to validate it in an ind...Continue Reading

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Citations

Aug 18, 2016·Clinical and Experimental Nephrology·Pierpaolo Di Nicolò, Antonio Granata
Oct 27, 2018·The Journal of Clinical Hypertension·Ioannis AndrikouDimitris Tousoulis
Mar 5, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Chava L RamspekMerel van Diepen
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Jun 12, 2020·The Journal of Vascular Access·Marica MagnettiLuigi Biancone
Jun 10, 2020·Histopathology·Gabriel StefanGabriel Mircescu
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Apr 4, 2021·Journal of Clinical Medicine·Charat ThongprayoonWisit Cheungpasitporn
Dec 18, 2021·International Journal of Epidemiology·Chava L RamspekMerel van Diepen

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