Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients

Background/Aims: Cerebrovascular disease (CeVD) is one of the leading causes of death in patients initialising peritoneal dialysis (PD). Currently there is no risk score to predict the future risk of CeVD on entry into PD. This study aimed to derive and validate a risk prediction model for CeVD mort...

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Main Authors: Xiaoxue Zhang, Dahai Yu, Yamei Cai, Jin Shang, Rui Qin, Xing Tian, Zhanzheng Zhao, David Simmons
Format: Article
Language:English
Published: Karger Publishers 2018-07-01
Series:Kidney & Blood Pressure Research
Subjects:
Online Access:https://www.karger.com/Article/FullText/492048
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author Xiaoxue Zhang
Dahai Yu
Yamei Cai
Jin Shang
Rui Qin
Xing Tian
Zhanzheng Zhao
David Simmons
author_facet Xiaoxue Zhang
Dahai Yu
Yamei Cai
Jin Shang
Rui Qin
Xing Tian
Zhanzheng Zhao
David Simmons
author_sort Xiaoxue Zhang
collection DOAJ
description Background/Aims: Cerebrovascular disease (CeVD) is one of the leading causes of death in patients initialising peritoneal dialysis (PD). Currently there is no risk score to predict the future risk of CeVD on entry into PD. This study aimed to derive and validate a risk prediction model for CeVD mortality in 2 years after the initialisation of PD. Methods: All patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014 were included. Multivariable logistic regression modelling was applied to derive the risk score. All accessible clinical measurements were screened as potential predictors. Internal validation through bootstrapping was applied to test the model performance. Results: The absolute risk of CeVD mortality was 2.9%. Systolic and diastolic blood pressure, total cholesterol, phosphate, and sodium concentrations were the strongest predictors of CeVD mortality in the final risk score. Good model discrimination with C statistics above 0.70 and calibration of agreed observed and predicted risks were identified in the model. Conclusion: The new risk score, developed and validated using clinical measurements that are accessible on entry into PD, could be used clinically to screen for patients at high risk of CeVD mortality. Such patients might benefit from therapies reducing the incidence of CeVD related events.
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spelling doaj.art-b59064152b7f4f4aacf9c1406dfecc002022-12-21T22:46:41ZengKarger PublishersKidney & Blood Pressure Research1420-40961423-01432018-07-014341141114810.1159/000492048492048Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis PatientsXiaoxue ZhangDahai YuYamei CaiJin ShangRui QinXing TianZhanzheng ZhaoDavid SimmonsBackground/Aims: Cerebrovascular disease (CeVD) is one of the leading causes of death in patients initialising peritoneal dialysis (PD). Currently there is no risk score to predict the future risk of CeVD on entry into PD. This study aimed to derive and validate a risk prediction model for CeVD mortality in 2 years after the initialisation of PD. Methods: All patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014 were included. Multivariable logistic regression modelling was applied to derive the risk score. All accessible clinical measurements were screened as potential predictors. Internal validation through bootstrapping was applied to test the model performance. Results: The absolute risk of CeVD mortality was 2.9%. Systolic and diastolic blood pressure, total cholesterol, phosphate, and sodium concentrations were the strongest predictors of CeVD mortality in the final risk score. Good model discrimination with C statistics above 0.70 and calibration of agreed observed and predicted risks were identified in the model. Conclusion: The new risk score, developed and validated using clinical measurements that are accessible on entry into PD, could be used clinically to screen for patients at high risk of CeVD mortality. Such patients might benefit from therapies reducing the incidence of CeVD related events.https://www.karger.com/Article/FullText/492048Cerebrovascular diseasesMortalityPeritoneal dialysisRisk prediction
spellingShingle Xiaoxue Zhang
Dahai Yu
Yamei Cai
Jin Shang
Rui Qin
Xing Tian
Zhanzheng Zhao
David Simmons
Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
Kidney & Blood Pressure Research
Cerebrovascular diseases
Mortality
Peritoneal dialysis
Risk prediction
title Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
title_full Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
title_fullStr Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
title_full_unstemmed Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
title_short Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis Patients
title_sort derivation and validation of risk scores to predict cerebrovascular mortality among incident peritoneal dialysis patients
topic Cerebrovascular diseases
Mortality
Peritoneal dialysis
Risk prediction
url https://www.karger.com/Article/FullText/492048
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