External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease
Background The Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, esp...
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| Veröffentlicht in: | Journal of nephrology 2024-03, Vol.37 (2), p.429-437 |
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| creator | Gallego-Valcarce, Eduardo Shabaka, Amir Tato-Ribera, Ana María Landaluce-Triska, Eugenia León-Poo, Mariana Roldan, Deborah Gruss, Enrique |
| description | Background
The Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, especially for predicting mortality before kidney failure.
Methods
We performed an external validation of the Grams and Kidney Failure Risk Equation prediction models in incident patients with CKD G4 + at Hospital Universitario Fundación Alcorcón, Spain, between 1/1/2014 and 31/12/2018, ending follow-up on 30/09/2023. Discrimination was performed calculating the area under the receiver-operating characteristic curve. Calibration was assessed using the Hosmer–Lemeshow test and the Brier score.
Results
The study included 339 patients (mean age 72.2 ± 12.7 years and baseline estimated glomerular filtration rate 20.6 ± 5.0 ml/min). Both models showed excellent discrimination. The area under the curve (AUC) for Kidney Failure Risk Equation-2 and Grams-2 were 0.894 (95% CI 0.857–0.931) and 0.897 (95%CI 0.859–0.935), respectively. For Grams-4 the AUC was 0.841 (95%CI 0.798–0.883), and for Kidney Failure Risk Equation-5 it was 0.823 (95% CI 0.779–0.867). For death before kidney failure, the Grams model showed acceptable discrimination (AUC 0.708 (95% CI 0.626–0.790) and 0.744 (95% CI 0.683–0.804) for Grams-2 and Grams-4, respectively). Both models presented excellent calibration for predicting kidney failure. Grams model calibration to estimate mortality before kidney failure was also excellent. In all cases, Hosmer–Lemeshow test resulted in a
p
-value greater than 0.05, and the Brier score was less than 0.20.
Conclusions
In a cohort of patients with CKD G4 + from southern Europe, both the Grams and Kidney Failure Risk Equation models are accurate in estimating the risk of kidney failure. Additionally, the Grams model provides a reliable estimate of the risk of mortality before kidney failure.
Graphical abstract |
| doi_str_mv | 10.1007/s40620-023-01819-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2899370399</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2899370399</sourcerecordid><originalsourceid>FETCH-LOGICAL-c298t-8078573af4d201ec3826aa3ed829fd5bf099ae6119d6a3be30b9699062aa282c3</originalsourceid><addsrcrecordid>eNp9kctu1DAUQC0Eou3AD7BAXrIJXNuTxF6ialpQKyHxWFt37BviktjBzrT0Y_hXMjMtYsXGtuRzjyUfxl4JeCsA2ndlDY2ECqSqQGhhKvGEnYpWrqsGavP0n_MJOyvlBkDWtVw_ZydKQwMC9Cn7vfk1U4448Fscgsc5pMhTx-ee-NXF5w3H6PllxrHwKZMP7gCMydNQeJcy_xF8pHveYRh2mQ64J5x7HiJH_mXCGErPXepTnvfiaXmC4lz4XVgg9LcYHXnu-pxicI86HwphoRfsWYdDoZcP-4p9u9h8Pf9QXX-6_Hj-_rpy0ui50tDqulXYrb0EQU5p2SAq8lqaztfbDoxBaoQwvkG1JQVb0xiz_B6i1NKpFXtz9E45_dxRme0YiqNhwEhpV6zUxqgW1LKumDyiLqdSMnV2ymHEfG8F2H0We8xilyz2kMWKZej1g3-3Hcn_HXnssADqCJTlKn6nbG_Sbp-l_E_7B1epmiA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2899370399</pqid></control><display><type>article</type><title>External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Gallego-Valcarce, Eduardo ; Shabaka, Amir ; Tato-Ribera, Ana María ; Landaluce-Triska, Eugenia ; León-Poo, Mariana ; Roldan, Deborah ; Gruss, Enrique</creator><creatorcontrib>Gallego-Valcarce, Eduardo ; Shabaka, Amir ; Tato-Ribera, Ana María ; Landaluce-Triska, Eugenia ; León-Poo, Mariana ; Roldan, Deborah ; Gruss, Enrique</creatorcontrib><description>Background
The Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, especially for predicting mortality before kidney failure.
Methods
We performed an external validation of the Grams and Kidney Failure Risk Equation prediction models in incident patients with CKD G4 + at Hospital Universitario Fundación Alcorcón, Spain, between 1/1/2014 and 31/12/2018, ending follow-up on 30/09/2023. Discrimination was performed calculating the area under the receiver-operating characteristic curve. Calibration was assessed using the Hosmer–Lemeshow test and the Brier score.
Results
The study included 339 patients (mean age 72.2 ± 12.7 years and baseline estimated glomerular filtration rate 20.6 ± 5.0 ml/min). Both models showed excellent discrimination. The area under the curve (AUC) for Kidney Failure Risk Equation-2 and Grams-2 were 0.894 (95% CI 0.857–0.931) and 0.897 (95%CI 0.859–0.935), respectively. For Grams-4 the AUC was 0.841 (95%CI 0.798–0.883), and for Kidney Failure Risk Equation-5 it was 0.823 (95% CI 0.779–0.867). For death before kidney failure, the Grams model showed acceptable discrimination (AUC 0.708 (95% CI 0.626–0.790) and 0.744 (95% CI 0.683–0.804) for Grams-2 and Grams-4, respectively). Both models presented excellent calibration for predicting kidney failure. Grams model calibration to estimate mortality before kidney failure was also excellent. In all cases, Hosmer–Lemeshow test resulted in a
p
-value greater than 0.05, and the Brier score was less than 0.20.
Conclusions
In a cohort of patients with CKD G4 + from southern Europe, both the Grams and Kidney Failure Risk Equation models are accurate in estimating the risk of kidney failure. Additionally, the Grams model provides a reliable estimate of the risk of mortality before kidney failure.
Graphical abstract</description><identifier>ISSN: 1724-6059</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-023-01819-1</identifier><identifier>PMID: 38060108</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Aged, 80 and over ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nephrology ; Original Article ; Predictive Value of Tests ; Prognosis ; Renal Insufficiency - diagnosis ; Renal Insufficiency - mortality ; Renal Insufficiency - physiopathology ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - physiopathology ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; ROC Curve ; Spain - epidemiology ; Urology</subject><ispartof>Journal of nephrology, 2024-03, Vol.37 (2), p.429-437</ispartof><rights>The Author(s) under exclusive licence to Italian Society of Nephrology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s) under exclusive licence to Italian Society of Nephrology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-8078573af4d201ec3826aa3ed829fd5bf099ae6119d6a3be30b9699062aa282c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40620-023-01819-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40620-023-01819-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38060108$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gallego-Valcarce, Eduardo</creatorcontrib><creatorcontrib>Shabaka, Amir</creatorcontrib><creatorcontrib>Tato-Ribera, Ana María</creatorcontrib><creatorcontrib>Landaluce-Triska, Eugenia</creatorcontrib><creatorcontrib>León-Poo, Mariana</creatorcontrib><creatorcontrib>Roldan, Deborah</creatorcontrib><creatorcontrib>Gruss, Enrique</creatorcontrib><title>External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J Nephrol</addtitle><description>Background
The Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, especially for predicting mortality before kidney failure.
Methods
We performed an external validation of the Grams and Kidney Failure Risk Equation prediction models in incident patients with CKD G4 + at Hospital Universitario Fundación Alcorcón, Spain, between 1/1/2014 and 31/12/2018, ending follow-up on 30/09/2023. Discrimination was performed calculating the area under the receiver-operating characteristic curve. Calibration was assessed using the Hosmer–Lemeshow test and the Brier score.
Results
The study included 339 patients (mean age 72.2 ± 12.7 years and baseline estimated glomerular filtration rate 20.6 ± 5.0 ml/min). Both models showed excellent discrimination. The area under the curve (AUC) for Kidney Failure Risk Equation-2 and Grams-2 were 0.894 (95% CI 0.857–0.931) and 0.897 (95%CI 0.859–0.935), respectively. For Grams-4 the AUC was 0.841 (95%CI 0.798–0.883), and for Kidney Failure Risk Equation-5 it was 0.823 (95% CI 0.779–0.867). For death before kidney failure, the Grams model showed acceptable discrimination (AUC 0.708 (95% CI 0.626–0.790) and 0.744 (95% CI 0.683–0.804) for Grams-2 and Grams-4, respectively). Both models presented excellent calibration for predicting kidney failure. Grams model calibration to estimate mortality before kidney failure was also excellent. In all cases, Hosmer–Lemeshow test resulted in a
p
-value greater than 0.05, and the Brier score was less than 0.20.
Conclusions
In a cohort of patients with CKD G4 + from southern Europe, both the Grams and Kidney Failure Risk Equation models are accurate in estimating the risk of kidney failure. Additionally, the Grams model provides a reliable estimate of the risk of mortality before kidney failure.
Graphical abstract</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Renal Insufficiency - diagnosis</subject><subject>Renal Insufficiency - mortality</subject><subject>Renal Insufficiency - physiopathology</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Spain - epidemiology</subject><subject>Urology</subject><issn>1724-6059</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUQC0Eou3AD7BAXrIJXNuTxF6ialpQKyHxWFt37BviktjBzrT0Y_hXMjMtYsXGtuRzjyUfxl4JeCsA2ndlDY2ECqSqQGhhKvGEnYpWrqsGavP0n_MJOyvlBkDWtVw_ZydKQwMC9Cn7vfk1U4448Fscgsc5pMhTx-ee-NXF5w3H6PllxrHwKZMP7gCMydNQeJcy_xF8pHveYRh2mQ64J5x7HiJH_mXCGErPXepTnvfiaXmC4lz4XVgg9LcYHXnu-pxicI86HwphoRfsWYdDoZcP-4p9u9h8Pf9QXX-6_Hj-_rpy0ui50tDqulXYrb0EQU5p2SAq8lqaztfbDoxBaoQwvkG1JQVb0xiz_B6i1NKpFXtz9E45_dxRme0YiqNhwEhpV6zUxqgW1LKumDyiLqdSMnV2ymHEfG8F2H0We8xilyz2kMWKZej1g3-3Hcn_HXnssADqCJTlKn6nbG_Sbp-l_E_7B1epmiA</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Gallego-Valcarce, Eduardo</creator><creator>Shabaka, Amir</creator><creator>Tato-Ribera, Ana María</creator><creator>Landaluce-Triska, Eugenia</creator><creator>León-Poo, Mariana</creator><creator>Roldan, Deborah</creator><creator>Gruss, Enrique</creator><general>Springer International Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240301</creationdate><title>External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease</title><author>Gallego-Valcarce, Eduardo ; Shabaka, Amir ; Tato-Ribera, Ana María ; Landaluce-Triska, Eugenia ; León-Poo, Mariana ; Roldan, Deborah ; Gruss, Enrique</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c298t-8078573af4d201ec3826aa3ed829fd5bf099ae6119d6a3be30b9699062aa282c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Renal Insufficiency - diagnosis</topic><topic>Renal Insufficiency - mortality</topic><topic>Renal Insufficiency - physiopathology</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Spain - epidemiology</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gallego-Valcarce, Eduardo</creatorcontrib><creatorcontrib>Shabaka, Amir</creatorcontrib><creatorcontrib>Tato-Ribera, Ana María</creatorcontrib><creatorcontrib>Landaluce-Triska, Eugenia</creatorcontrib><creatorcontrib>León-Poo, Mariana</creatorcontrib><creatorcontrib>Roldan, Deborah</creatorcontrib><creatorcontrib>Gruss, Enrique</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gallego-Valcarce, Eduardo</au><au>Shabaka, Amir</au><au>Tato-Ribera, Ana María</au><au>Landaluce-Triska, Eugenia</au><au>León-Poo, Mariana</au><au>Roldan, Deborah</au><au>Gruss, Enrique</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease</atitle><jtitle>Journal of nephrology</jtitle><stitle>J Nephrol</stitle><addtitle>J Nephrol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>37</volume><issue>2</issue><spage>429</spage><epage>437</epage><pages>429-437</pages><issn>1724-6059</issn><eissn>1724-6059</eissn><abstract>Background
The Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, especially for predicting mortality before kidney failure.
Methods
We performed an external validation of the Grams and Kidney Failure Risk Equation prediction models in incident patients with CKD G4 + at Hospital Universitario Fundación Alcorcón, Spain, between 1/1/2014 and 31/12/2018, ending follow-up on 30/09/2023. Discrimination was performed calculating the area under the receiver-operating characteristic curve. Calibration was assessed using the Hosmer–Lemeshow test and the Brier score.
Results
The study included 339 patients (mean age 72.2 ± 12.7 years and baseline estimated glomerular filtration rate 20.6 ± 5.0 ml/min). Both models showed excellent discrimination. The area under the curve (AUC) for Kidney Failure Risk Equation-2 and Grams-2 were 0.894 (95% CI 0.857–0.931) and 0.897 (95%CI 0.859–0.935), respectively. For Grams-4 the AUC was 0.841 (95%CI 0.798–0.883), and for Kidney Failure Risk Equation-5 it was 0.823 (95% CI 0.779–0.867). For death before kidney failure, the Grams model showed acceptable discrimination (AUC 0.708 (95% CI 0.626–0.790) and 0.744 (95% CI 0.683–0.804) for Grams-2 and Grams-4, respectively). Both models presented excellent calibration for predicting kidney failure. Grams model calibration to estimate mortality before kidney failure was also excellent. In all cases, Hosmer–Lemeshow test resulted in a
p
-value greater than 0.05, and the Brier score was less than 0.20.
Conclusions
In a cohort of patients with CKD G4 + from southern Europe, both the Grams and Kidney Failure Risk Equation models are accurate in estimating the risk of kidney failure. Additionally, the Grams model provides a reliable estimate of the risk of mortality before kidney failure.
Graphical abstract</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38060108</pmid><doi>10.1007/s40620-023-01819-1</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Female Glomerular Filtration Rate Humans Male Medicine Medicine & Public Health Middle Aged Nephrology Original Article Predictive Value of Tests Prognosis Renal Insufficiency - diagnosis Renal Insufficiency - mortality Renal Insufficiency - physiopathology Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - mortality Renal Insufficiency, Chronic - physiopathology Reproducibility of Results Risk Assessment Risk Factors ROC Curve Spain - epidemiology Urology |
| title | External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease |
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