A simple tool to predict end-stage renal disease within 1 year in elderly adults with advanced chronic kidney disease.
A simple tool to predict end-stage renal disease within 1 year in elderly adults with advanced chronic kidney disease.
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DOI：
10.1111/jgs.12223
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发表时间：
2013-05
影响因子：
6.3
通讯作者：
Rahman M
中科院分区：
文献类型：
--
作者：
Drawz PE;Goswami P;Azem R;Babineau DC;Rahman M
慢性肾脏病（CKD）在老年患者中很常见;目前，没有工具可用于预测1年内终末期肾脏病（ESRD）的风险。本研究的目的是开发并验证一种模型，以预测晚期CKD老年受试者的1年ESRD风险。回顾性研究退伍军人事务医疗中心65岁以上的CKD患者，估计（eGFR）低于30 mL/min/1.73 m2。结局为eGFR指数1年内的ESRD。考克斯回归用于开发预测模型（VA风险评分），该模型在单独的队列中得到验证。在发育队列的1，866例患者中，77例发展为ESRD。最终模型中ESRD的危险因素为年龄、充血性心力衰竭、收缩压、eGFR、钾和白蛋白。在验证队列中，VA风险评分的C指数为0.823。1年时发生ESRD的危险性从最低到最高三分位数分别为0.08%、2.7%和11.3%（P<0.001）。最近发表的Tangri模型在验证队列中的C指数为0.780。一个新的模型，使用常用的临床措施显示出良好的能力，预测未来一年内发生的ESRD老年受试者。此外，Tangri模型具有很好的预测能力。患者和医生可以使用这些风险模型为晚期CKD患者的肾脏替代治疗准备决策提供信息。
Chronic kidney disease (CKD) is common in older patients; currently, no tools are available to predict the risk of end-stage renal disease (ESRD) within 1 year. The goal of this study was to develop and validate a model to predict the 1 year risk for ESRD in elderly subjects with advanced CKD. Retrospective study Veterans Affairs Medical Center Patients over 65 years of age with CKD with an estimated (eGFR) less than 30mL/min/1.73m2. The outcome was ESRD within 1 year of the index eGFR. Cox regression was used to develop a predictive model (VA risk score) which was validated in a separate cohort. Of the 1,866 patients 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% (P<0.001). The C-index for the recently published Tangri model in the validation cohort was 0.780. A new model using commonly available clinical measures shows excellent ability to predict the onset of ESRD within the next year in elderly subjects. Additionally, the Tangri model had very good predictive ability. Patients and physicians can use these risk models to inform decisions regarding preparation for renal replacement therapy in patients with advanced CKD.
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影响因子：
158.5
作者：
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通讯作者：
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