Development and validation of a risk score for the prediction of cardiovascular disease in living donor kidney transplant recipients
Development and validation of a risk score for the prediction of cardiovascular disease in living donor kidney transplant recipients
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开发和验证活体肾移植受者心血管疾病预测风险评分
DOI：
10.1093/ndt/gfaa275
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Kitazono T; Japan Academic Consortium of Kidney Transplantation investig
中科院分区：
文献类型：
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作者：
Ueki K;Tsuchimoto A;Matsukuma Y;Nakagawa K;Tsujikawa H;Masutani K;Tanaka S;Kaku K;Noguchi H;Okabe Y;Unagami K;Kakuta Y;Okumi M;Nakamura M;Tsuruya K;Nakano T;Tanabe K;Kitazono T; Japan Academic Consortium of Kidney Transplantation investig
背景心血管疾病（CVD）是肾移植（KT）受者死亡的主要原因.为了提高他们的长期生存，这是临床上重要的是通过适当的移植前CVD screening.MethodsA衍生队列包含331 KT受体活体供体KT后，估计CVD的风险在九州大学医院从2006年1月至2012年12月。回顾性开发预测模型，并通过考克斯比例风险回归模型研究风险评分。通过c-统计量和Hosmer-Lemeshow拟合优度检验估计预测模型的鉴别和校准能力。外部验证估计通过相同的统计方法，通过应用该模型进行活体供体KT在东京女子医科大学Hospital.ResultsIn的推导队列，28例（8.5%）在观察期间的CVD事件的验证队列的300 KT收件人。肾移植术后12个月时的透析时间、糖尿病肾病、糖尿病肾病、心血管病史、血清白蛋白和尿蛋白是心血管病的重要预测因素。由整数风险评分组成的预测模型表现出良好的区分度（c-统计量0.88）和拟合优度（Hosmer-Lemeshow检验P=0.18）。在一个验证队列中，该模型表现出中度歧视（c-统计0.77）和拟合优度（Hosmer-Lemeshow检验P=0.15），表明外部validity.ConclusionsThe上述简单模型预测CVD后，活体供体KT是准确的，在临床情况下是有用的。
BackgroundCardiovascular disease (CVD) is a major cause of death in kidney transplant (KT) recipients. To improve their long-term survival, it is clinically important to estimate the risk of CVD after living donor KT via adequate pre-transplant CVD screening.MethodsA derivation cohort containing 331 KT recipients underwent living donor KT at Kyushu University Hospital from January 2006 to December 2012. A prediction model was retrospectively developed and risk scores were investigated via a Cox proportional hazards regression model. The discrimination and calibration capacities of the prediction model were estimated via the c-statistic and the Hosmer–Lemeshow goodness of fit test. External validation was estimated via the same statistical methods by applying the model to a validation cohort of 300 KT recipients who underwent living donor KT at Tokyo Women’s Medical University Hospital.ResultsIn the derivation cohort, 28 patients (8.5%) had CVD events during the observation period. Recipient age, CVD history, diabetic nephropathy, dialysis vintage, serum albumin and proteinuria at 12 months after KT were significant predictors of CVD. A prediction model consisting of integer risk scores demonstrated good discrimination (c-statistic 0.88) and goodness of fit (Hosmer–Lemeshow test P=0.18). In a validation cohort, the model demonstrated moderate discrimination (c-statistic 0.77) and goodness of fit (Hosmer–Lemeshow test P=0.15), suggesting external validity.ConclusionsThe above-described simple model for predicting CVD after living donor KT was accurate and useful in clinical situations.