CKD stage-specific utility of two equations for predicting 1-year risk of ESKD.
<h4>Background</h4>The Kidney Failure Risk Equation (KFRE) and Kaiser Permanente Northwest (KPNW) models have been proposed to predict progression to ESKD among adults with CKD within 2 and 5 years. We evaluated the utility of these equations to predict the 1-year risk of ESKD in a conte...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293293&type=printable |
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| author | Sijie Zheng Rishi V Parikh Thida C Tan Leonid Pravoverov Jignesh K Patel Kate M Horiuchi Alan S Go |
| author_facet | Sijie Zheng Rishi V Parikh Thida C Tan Leonid Pravoverov Jignesh K Patel Kate M Horiuchi Alan S Go |
| author_sort | Sijie Zheng |
| collection | DOAJ |
| description | <h4>Background</h4>The Kidney Failure Risk Equation (KFRE) and Kaiser Permanente Northwest (KPNW) models have been proposed to predict progression to ESKD among adults with CKD within 2 and 5 years. We evaluated the utility of these equations to predict the 1-year risk of ESKD in a contemporary, ethnically diverse CKD population.<h4>Methods</h4>We conducted a retrospective cohort study of adult members of Kaiser Permanente Northern California (KPNC) with CKD Stages 3-5 from January 2008-September 2015. We ascertained the onset of ESKD through September 2016, and calculated stage-specific estimates of model discrimination and calibration for the KFRE and KPNW equations.<h4>Results</h4>We identified 108,091 eligible adults with CKD (98,757 CKD Stage 3; 8,384 CKD Stage 4; and 950 CKD Stage 5 not yet receiving kidney replacement therapy), with mean age of 75 years, 55% women, and 37% being non-white. The overall 1-year risk of ESKD was 0.8% (95%CI: 0.8-0.9%). The KFRE displayed only moderate discrimination for CKD 3 and 5 (c = 0.76) but excellent discrimination for CKD 4 (c = 0.86), with good calibration for CKD 3-4 patients but suboptimal calibration for CKD 5. Calibration by CKD stage was similar to KFRE for the KPNW equation but displayed worse calibration across CKD stages for 1-year ESKD prediction.<h4>Conclusions</h4>In a large, ethnically diverse, community-based CKD 3-5 population, both the KFRE and KPNW equation were suboptimal in accurately predicting the 1-year risk of ESKD within CKD stage 3 and 5, but more accurate for stage 4. Our findings suggest these equations can be used in1-year prediction for CKD 4 patients, but also highlight the need for more personalized, stage-specific equations that predicted various short- and long-term adverse outcomes to better inform overall decision-making. |
| first_indexed | 2024-03-11T12:19:11Z |
| format | Article |
| id | doaj.art-dfb177b0739e4ccfb01b6f7181a55511 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-11T12:19:11Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-dfb177b0739e4ccfb01b6f7181a555112023-11-07T05:34:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011811e029329310.1371/journal.pone.0293293CKD stage-specific utility of two equations for predicting 1-year risk of ESKD.Sijie ZhengRishi V ParikhThida C TanLeonid PravoverovJignesh K PatelKate M HoriuchiAlan S Go<h4>Background</h4>The Kidney Failure Risk Equation (KFRE) and Kaiser Permanente Northwest (KPNW) models have been proposed to predict progression to ESKD among adults with CKD within 2 and 5 years. We evaluated the utility of these equations to predict the 1-year risk of ESKD in a contemporary, ethnically diverse CKD population.<h4>Methods</h4>We conducted a retrospective cohort study of adult members of Kaiser Permanente Northern California (KPNC) with CKD Stages 3-5 from January 2008-September 2015. We ascertained the onset of ESKD through September 2016, and calculated stage-specific estimates of model discrimination and calibration for the KFRE and KPNW equations.<h4>Results</h4>We identified 108,091 eligible adults with CKD (98,757 CKD Stage 3; 8,384 CKD Stage 4; and 950 CKD Stage 5 not yet receiving kidney replacement therapy), with mean age of 75 years, 55% women, and 37% being non-white. The overall 1-year risk of ESKD was 0.8% (95%CI: 0.8-0.9%). The KFRE displayed only moderate discrimination for CKD 3 and 5 (c = 0.76) but excellent discrimination for CKD 4 (c = 0.86), with good calibration for CKD 3-4 patients but suboptimal calibration for CKD 5. Calibration by CKD stage was similar to KFRE for the KPNW equation but displayed worse calibration across CKD stages for 1-year ESKD prediction.<h4>Conclusions</h4>In a large, ethnically diverse, community-based CKD 3-5 population, both the KFRE and KPNW equation were suboptimal in accurately predicting the 1-year risk of ESKD within CKD stage 3 and 5, but more accurate for stage 4. Our findings suggest these equations can be used in1-year prediction for CKD 4 patients, but also highlight the need for more personalized, stage-specific equations that predicted various short- and long-term adverse outcomes to better inform overall decision-making.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293293&type=printable |
| spellingShingle | Sijie Zheng Rishi V Parikh Thida C Tan Leonid Pravoverov Jignesh K Patel Kate M Horiuchi Alan S Go CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. PLoS ONE |
| title | CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. |
| title_full | CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. |
| title_fullStr | CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. |
| title_full_unstemmed | CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. |
| title_short | CKD stage-specific utility of two equations for predicting 1-year risk of ESKD. |
| title_sort | ckd stage specific utility of two equations for predicting 1 year risk of eskd |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0293293&type=printable |
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