External validation of a proposed prognostic model for the prediction of 1-year postoperative eGFR after living donor nephrectomy
External validation of a proposed prognostic model for the prediction of 1-year postoperative eGFR after living donor nephrectomy
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DOI：
10.1007/s11255-017-1683-y
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发表时间：
2017-11-01
影响因子：
2
通讯作者：
Schrem, Harald
中科院分区：
文献类型：
--
作者：
Kulik, Ulf;Gwiasda, Jill;Schrem, Harald
本研究的目的是从外部验证最近提出的预测模型，用于预测活体肾切除术后 1 年估计肾小球滤过率 (eGFR) < 60 ml/min/1.73 m(2)。2000 年 3 月至 2016 年 4 月期间，对 130 名活体肾捐献者（捐献时中位年龄 52.3 岁，范围 24.7-75.6 岁）进行了调查。 eGFR 值在 61.7 至 148.4 ml/min 之间变化（平均值：89，中位数：88）。移植后 1 年（+/- 45 天）观察到的 eGFR 范围在 36.3 至 97.1 ml/min 之间（平均值：55，中位数：53）。 70.8% 的捐献者在捐献后 1 年后表现出 eGFR 值 < 60 ml/min。使用 Benoit 等人提出的预后模型确定捐赠后 1 年的预测 eGFR。 (Int Urol Nephrol 49(5):793-801. doi:10.1007/s11255-017-1559-1, 2017)：术后 eGFR ml/min/1.73 m(2) = 31.71 + (0.521 x 捐献前 eGFR (ml/min) -0.314 x 捐献时的年龄)。 Pearson 相关性和受试者工作特征曲线（ROC 曲线）用于评估所提出的预后模型的外部有效性，以预测术后 eGFR（以 ml/min 和 eGFR < 60 ml/min 为单位）。捐赠后 1 年预测的 eGFR 与观察到的 eGFR 之间的相关性显着（p < 0.001；R-2 = 0.594）。 ROC 曲线下面积 (AUROC) 对预测 eGFR 值 < 60 ml/min (AUROC = 0.866) 表现出高敏感性和特异性。所提出的预测术后 eGFR 的预后模型在我们的队列中得到了成功验证。因此，我们认为该模型具有普遍适用性。
The goal of this study was to externally validate the recently proposed prognostic model for the prediction of estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m(2) 1 year after living donor nephrectomy.130 living kidney donors (median age at donation 52.3 years, range 24.7-75.6 years) were investigated before and after donation between March 2000 and April 2016. Preoperative eGFR values varied between 61.7 and 148.4 ml/min (mean: 89, median: 88). Observed eGFR 1 year after transplantation (+/- 45 days) ranged between 36.3 and 97.1 ml/min (mean: 55, median: 53). 70.8% of donors displayed eGFR values < 60 ml/min 1 year after donation. Predicted eGFR 1 year after donation was determined using the prognostic model proposed by Benoit et al. (Int Urol Nephrol 49(5):793-801. doi:10.1007/s11255-017-1559-1, 2017): postoperative eGFR ml/min/1.73 m(2) = 31.71 + (0.521 x eGFR in ml/min prior to donation -0.314 x Age in years at donation). Pearson correlation and receiver operating characteristics curve (ROC-curve) were used to assess external validity of the proposed prognostic model to predict postoperative eGFR in ml/min and eGFR < 60 ml/min.The correlation between predicted and observed eGFR 1 year after donation was significant (p < 0.001; R-2 = 0.594). The area under the ROC-curve (AUROC) demonstrated a high sensitivity and specificity for predicted eGFR values < 60 ml/min (AUROC = 0.866).The proposed prognostic model for the prediction of postoperative eGFR was successfully validated in our cohort. We therefore consider the model as generally applicable.