scholarly journals External validation and clinical utility of a prediction model for 6-month mortality in patients undergoing hemodialysis for end-stage kidney disease

2017 ◽  
Vol 32 (2) ◽  
pp. 395-403 ◽  
Author(s):  
Brian Forzley ◽  
Lee Er ◽  
Helen HL Chiu ◽  
Ognjenka Djurdjev ◽  
Dan Martinusen ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Prediction Model ◽  
Clinical Utility ◽  
External Validation ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes

2021 ◽  
Author(s):  
Dorte Vistisen ◽  
Gregers S. Andersen ◽  
Adam Hulman ◽  
Stuart J. McGurnaghan ◽  
Helen M. Colhoun ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Prediction Model ◽  
Clinical Decision Making ◽  
External Validation ◽  
End Stage Kidney Disease ◽  
Risk Of Death ◽  
Increased Risk ◽  
End Stage

<b>OBJECTIVE </b> <p>End-stage kidney disease (ESKD) is a life-threatening complication of diabetes which can be prevented or delayed by intervention. Hence, early detection of persons at increased risk is essential.</p> <p> </p> <p><b>RESEARCH DESIGN AND METHODS </b></p> <p>From a population-based cohort of 5,460 clinically diagnosed Danish adults with type 1 diabetes followed 2001-2016, we developed a prediction model for ESKD accounting for the competing risk of death. Poisson regression analysis was used to estimate the model based on information routinely collected from clinical examinations. The effect of including an extended set of predictors (lipids, alcohol intake etc.) was further evaluated, and potential interactions identified in a survival tree analysis were tested. The final model was externally validated in 9,175 adults from Denmark and Scotland.</p> <p> </p> <p><b>RESULTS</b> </p> <p>During a median follow-up of 10.4 years (interquartile limits: 5.1;14.7), 303 (5.5%) of the participants (mean (SD) age 42.3 (16.5) years) developed ESKD and 764 (14.0%) died without having developed ESKD. The final ESKD prediction model included age, male sex, diabetes duration, estimated glomerular filtration rate, micro- and macroalbuminuria, systolic blood pressure, HbA<sub>1c</sub>, smoking and previous cardiovascular disease. Discrimination was excellent for 5-year risk of ESKD event with a C-statistic of 0.888 (95%CI: 0.849;0.927) in the derivation cohort and confirmed at 0.865 (0.811;0.919) and 0.961 (0.940;0.981) in the external validation cohorts from Denmark and Scotland. </p> <p> </p> <p><b>CONCLUSIONS</b> </p> <p>We have derived and validated a novel, high-performing ESKD prediction model for risk stratification in the adult type 1 diabetes population. This model may improve clinical decision making and potentially guide early intervention.</p>

scholarly journals A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes

2021 ◽  
Author(s):  
Dorte Vistisen ◽  
Gregers S. Andersen ◽  
Adam Hulman ◽  
Stuart J. McGurnaghan ◽  
Helen M. Colhoun ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Prediction Model ◽  
Clinical Decision Making ◽  
External Validation ◽  
End Stage Kidney Disease ◽  
Risk Of Death ◽  
Increased Risk ◽  
End Stage

<b>OBJECTIVE </b> <p>End-stage kidney disease (ESKD) is a life-threatening complication of diabetes which can be prevented or delayed by intervention. Hence, early detection of persons at increased risk is essential.</p> <p> </p> <p><b>RESEARCH DESIGN AND METHODS </b></p> <p>From a population-based cohort of 5,460 clinically diagnosed Danish adults with type 1 diabetes followed 2001-2016, we developed a prediction model for ESKD accounting for the competing risk of death. Poisson regression analysis was used to estimate the model based on information routinely collected from clinical examinations. The effect of including an extended set of predictors (lipids, alcohol intake etc.) was further evaluated, and potential interactions identified in a survival tree analysis were tested. The final model was externally validated in 9,175 adults from Denmark and Scotland.</p> <p> </p> <p><b>RESULTS</b> </p> <p>During a median follow-up of 10.4 years (interquartile limits: 5.1;14.7), 303 (5.5%) of the participants (mean (SD) age 42.3 (16.5) years) developed ESKD and 764 (14.0%) died without having developed ESKD. The final ESKD prediction model included age, male sex, diabetes duration, estimated glomerular filtration rate, micro- and macroalbuminuria, systolic blood pressure, HbA<sub>1c</sub>, smoking and previous cardiovascular disease. Discrimination was excellent for 5-year risk of ESKD event with a C-statistic of 0.888 (95%CI: 0.849;0.927) in the derivation cohort and confirmed at 0.865 (0.811;0.919) and 0.961 (0.940;0.981) in the external validation cohorts from Denmark and Scotland. </p> <p> </p> <p><b>CONCLUSIONS</b> </p> <p>We have derived and validated a novel, high-performing ESKD prediction model for risk stratification in the adult type 1 diabetes population. This model may improve clinical decision making and potentially guide early intervention.</p>

scholarly journals A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes. Diabetes Care 2021;44:901–907

Diabetes Care ◽  
2021 ◽  
pp. dci210010
Author(s):  
Dorte Vistisen ◽  
Gregers S. Andersen ◽  
Adam Hulman ◽  
Stuart J. McGurnaghan ◽  
Helen M. Colhoun ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Prediction Model ◽  
Diabetes Care ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes. Diabetes Care 2021;44:901–907

Diabetes Care ◽  
2021 ◽  
pp. dc210364
Author(s):  
Helena Bleken Østergaard ◽  
Joep van der Leeuw ◽  
Frank L.J. Visseren ◽  
Jan Westerink
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Prediction Model ◽  
Diabetes Care ◽  
End Stage Kidney Disease ◽  
End Stage

scholarly journals A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes

Diabetes Care ◽  
2021 ◽  
pp. dc202586
Author(s):  
Dorte Vistisen ◽  
Gregers S. Andersen ◽  
Adam Hulman ◽  
Stuart J. McGurnaghan ◽  
Helen M. Colhoun ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Prediction Model ◽  
End Stage Kidney Disease ◽  
End Stage

Impaired Vitamin D Signaling Is Associated With Frequent Development of Renal Cell Tumor in End-stage Kidney Disease

2020 ◽  
Vol 40 (11) ◽  
pp. 6525-6530
Author(s):  
JANOS DOCS ◽  
DANIEL BANYAI ◽  
TIBOR FLASKO ◽  
ARPAD SZANTO ◽  
GYULA KOVACS
Keyword(s):  
Vitamin D ◽  
Kidney Disease ◽  
Renal Cell ◽  
Cell Tumor ◽  
End Stage Kidney Disease ◽  
Vitamin D Signaling ◽  
End Stage

scholarly journals Cardiopulmonary exercise testing (CPET) in patients with end-stage kidney disease (ESKD): principles, methodology and clinical applications of the optimal tool for exercise tolerance evaluation

2021 ◽  
Author(s):  
Eva Pella ◽  
Afroditi Boutou ◽  
Aristi Boulmpou ◽  
Christodoulos E Papadopoulos ◽  
Aikaterini Papagianni ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Intolerance ◽  
End Stage Kidney Disease ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise ◽  
Functional Reserves ◽  
Increased Risk ◽  
End Stage

Abstract Chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), is associated with increased risk for cardiovascular events and all-cause mortality. Exercise intolerance as well as reduced cardiovascular reserve are extremely common in patients with CKD. Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic technique that provides an integrative evaluation of cardiovascular, pulmonary, neuropsychological and metabolic function during maximal or submaximal exercise, allowing the evaluation of functional reserves of these systems. This assessment is based on the principle that system failure typically occurs when the system is under stress and, thus, CPET is currently considered to be the gold-standard for identifying exercise limitation and differentiating its causes. It has been widely used in several medical fields for risk stratification, clinical evaluation and other applications but its use in everyday practice for CKD patients is scarce. This article describes the basic principles and methodology of CPET and provides an overview of important studies that utilized CPET in patients with ESKD, in an effort to increase awareness of CPET capabilities among practicing nephrologists.

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