Validation of the Kidney Failure Risk Equation in the Colombian Population
Introduction. Chronic kidney disease prevention programs must identify patients at risk of early progression to provide better treatment and prolong kidney replacement therapy-free survival. Risk equations have been developed and validated in cohorts outside of Colombia, so this study aims to evalua...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2024-01-01
|
| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2024/1282664 |
| _version_ | 1797295799410884608 |
|---|---|
| author | C. Larrarte J. Vesga F. Ardila A. Aldana D. Perea M. Sanabria |
| author_facet | C. Larrarte J. Vesga F. Ardila A. Aldana D. Perea M. Sanabria |
| author_sort | C. Larrarte |
| collection | DOAJ |
| description | Introduction. Chronic kidney disease prevention programs must identify patients at risk of early progression to provide better treatment and prolong kidney replacement therapy-free survival. Risk equations have been developed and validated in cohorts outside of Colombia, so this study aims to evaluate the discrimination and calibration of the four-variable kidney failure risk equation in a Colombian population where it has yet to be validated. Methods. External validation study of a kidney failure risk equation using a historical cohort of patients with CKD stages 3, 4, and 5, adults without a history of dialysis or kidney transplantation with a two-year follow-up, belonging to the Baxter Renal Care Services Colombia network. The discriminatory capacity of the model was evaluated by the concordance index using Harrell’s C statistic, and the time-dependent area under the receiver operating characteristic (ROC) curve was estimated using the nearest neighbor method, as well as the optimal cut-off point for sensitivity and specificity. Calibration was determined by the degree of agreement between the observed outcome and the probabilities predicted by the model using the Hosmer–Lemeshow statistic. Results. A total of 5,477 patients were included, with a mean age of 72 years, 36.4% diabetic, and a mean baseline eGFR of 36 ml/min/1.73 m2. The rate of dialysis initiation was three events per 100 patient-years, 95% CI (2.9–3.6). The optimal cutoff for sensitivity was 0.94, for specificity, 0.76, and the area under the ROC curve was 0.92. Harrell’s C-statistic was 0.88 for the total population, 0.88 for diabetic patients, and 0.93 for those 65 years or older. The validation of the model showed good calibration. Conclusions. In this Colombian cohort, the four-variable KFRE with a two-year prediction horizon has excellent calibration and discrimination, and its use in the care of CKD Colombian patients is recommended. |
| first_indexed | 2024-03-07T21:54:11Z |
| format | Article |
| id | doaj.art-4b7376f7ab9b4b2393041cd05258f658 |
| institution | Directory Open Access Journal |
| issn | 2090-2158 |
| language | English |
| last_indexed | 2024-03-07T21:54:11Z |
| publishDate | 2024-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj.art-4b7376f7ab9b4b2393041cd05258f6582024-02-25T00:00:01ZengHindawi LimitedInternational Journal of Nephrology2090-21582024-01-01202410.1155/2024/1282664Validation of the Kidney Failure Risk Equation in the Colombian PopulationC. Larrarte0J. Vesga1F. Ardila2A. Aldana3D. Perea4M. Sanabria5Baxter Renal Care ServicesBaxter Renal Care ServicesBaxter Renal Care Services-Latin AmericaBaxter Renal Care ServicesBaxter Renal Care ServicesBaxter Renal Care Services-Latin AmericaIntroduction. Chronic kidney disease prevention programs must identify patients at risk of early progression to provide better treatment and prolong kidney replacement therapy-free survival. Risk equations have been developed and validated in cohorts outside of Colombia, so this study aims to evaluate the discrimination and calibration of the four-variable kidney failure risk equation in a Colombian population where it has yet to be validated. Methods. External validation study of a kidney failure risk equation using a historical cohort of patients with CKD stages 3, 4, and 5, adults without a history of dialysis or kidney transplantation with a two-year follow-up, belonging to the Baxter Renal Care Services Colombia network. The discriminatory capacity of the model was evaluated by the concordance index using Harrell’s C statistic, and the time-dependent area under the receiver operating characteristic (ROC) curve was estimated using the nearest neighbor method, as well as the optimal cut-off point for sensitivity and specificity. Calibration was determined by the degree of agreement between the observed outcome and the probabilities predicted by the model using the Hosmer–Lemeshow statistic. Results. A total of 5,477 patients were included, with a mean age of 72 years, 36.4% diabetic, and a mean baseline eGFR of 36 ml/min/1.73 m2. The rate of dialysis initiation was three events per 100 patient-years, 95% CI (2.9–3.6). The optimal cutoff for sensitivity was 0.94, for specificity, 0.76, and the area under the ROC curve was 0.92. Harrell’s C-statistic was 0.88 for the total population, 0.88 for diabetic patients, and 0.93 for those 65 years or older. The validation of the model showed good calibration. Conclusions. In this Colombian cohort, the four-variable KFRE with a two-year prediction horizon has excellent calibration and discrimination, and its use in the care of CKD Colombian patients is recommended.http://dx.doi.org/10.1155/2024/1282664 |
| spellingShingle | C. Larrarte J. Vesga F. Ardila A. Aldana D. Perea M. Sanabria Validation of the Kidney Failure Risk Equation in the Colombian Population International Journal of Nephrology |
| title | Validation of the Kidney Failure Risk Equation in the Colombian Population |
| title_full | Validation of the Kidney Failure Risk Equation in the Colombian Population |
| title_fullStr | Validation of the Kidney Failure Risk Equation in the Colombian Population |
| title_full_unstemmed | Validation of the Kidney Failure Risk Equation in the Colombian Population |
| title_short | Validation of the Kidney Failure Risk Equation in the Colombian Population |
| title_sort | validation of the kidney failure risk equation in the colombian population |
| url | http://dx.doi.org/10.1155/2024/1282664 |
| work_keys_str_mv | AT clarrarte validationofthekidneyfailureriskequationinthecolombianpopulation AT jvesga validationofthekidneyfailureriskequationinthecolombianpopulation AT fardila validationofthekidneyfailureriskequationinthecolombianpopulation AT aaldana validationofthekidneyfailureriskequationinthecolombianpopulation AT dperea validationofthekidneyfailureriskequationinthecolombianpopulation AT msanabria validationofthekidneyfailureriskequationinthecolombianpopulation |