Risk Prediction Models for Patients With Chronic Kidney Disease

2013 ◽  
Vol 158 (8) ◽  
pp. 596 ◽  
Author(s):  
Navdeep Tangri ◽  
Georgios D. Kitsios ◽  
Lesley Ann Inker ◽  
John Griffith ◽  
David M. Naimark ◽  
...  
PRILOZI ◽  
2016 ◽  
Vol 37 (2-3) ◽  
pp. 33-42 ◽  
Author(s):  
Marijke Stryckers ◽  
Evi V Nagler ◽  
Wim Van Biesen

AbstractAs people age, chronic kidney disease becomes more common, but it rarely leads to end-stage kidney disease. When it does, the choice between dialysis and conservative care can be daunting, as much depends on life expectancy and personal expectations of medical care. Shared decision making implies adequately informing patients about their options, and facilitating deliberation of the available information, such that decisions are tailored to the individual’s values and preferences. Accurate estimations of one’s risk of progression to end-stage kidney disease and death with or without dialysis are essential for shared decision making to be effective. Formal risk prediction models can help, provided they are externally validated, well-calibrated and discriminative; include unambiguous and measureable variables; and come with readily applicable equations or scores. Reliable, externally validated risk prediction models for progression of chronic kidney disease to end-stage kidney disease or mortality in frail elderly with or without chronic kidney disease are scant. Within this paper, we discuss a number of promising models, highlighting both the strengths and limitations physicians should understand for using them judiciously, and emphasize the need for external validation over new development for further advancing the field.


Author(s):  
Chin-Chuan Shih ◽  
Chi-Jie Lu ◽  
Gin-Den Chen ◽  
Chi-Chang Chang

Developing effective risk prediction models is a cost-effective approach to predicting complications of chronic kidney disease (CKD) and mortality rates; however, there is inadequate evidence to support screening for CKD. In this study, four data mining algorithms, including a classification and regression tree, a C4.5 decision tree, a linear discriminant analysis, and an extreme learning machine, are used to predict early CKD. The study includes datasets from 19,270 patients, provided by an adult health examination program from 32 chain clinics and three special physical examination centers, between 2015 and 2019. There were 11 independent variables, and the glomerular filtration rate (GFR) was used as the predictive variable. The C4.5 decision tree algorithm outperformed the three comparison models for predicting early CKD based on accuracy, sensitivity, specificity, and area under the curve metrics. It is, therefore, a promising method for early CKD prediction. The experimental results showed that Urine protein and creatinine ratio (UPCR), Proteinuria (PRO), Red blood cells (RBC), Glucose Fasting (GLU), Triglycerides (TG), Total Cholesterol (T-CHO), age, and gender are important risk factors. CKD care is closely related to primary care level and is recognized as a healthcare priority in national strategy. The proposed risk prediction models can support the important influence of personality and health examination representations in predicting early CKD.


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1495
Author(s):  
Tú Nguyen-Dumont ◽  
James G. Dowty ◽  
Robert J. MacInnis ◽  
Jason A. Steen ◽  
Moeen Riaz ◽  
...  

While gene panel sequencing is becoming widely used for cancer risk prediction, its clinical utility with respect to predicting aggressive prostate cancer (PrCa) is limited by our current understanding of the genetic risk factors associated with predisposition to this potentially lethal disease phenotype. This study included 837 men diagnosed with aggressive PrCa and 7261 controls (unaffected men and men who did not meet criteria for aggressive PrCa). Rare germline pathogenic variants (including likely pathogenic variants) were identified by targeted sequencing of 26 known or putative cancer predisposition genes. We found that 85 (10%) men with aggressive PrCa and 265 (4%) controls carried a pathogenic variant (p < 0.0001). Aggressive PrCa odds ratios (ORs) were estimated using unconditional logistic regression. Increased risk of aggressive PrCa (OR (95% confidence interval)) was identified for pathogenic variants in BRCA2 (5.8 (2.7–12.4)), BRCA1 (5.5 (1.8–16.6)), and ATM (3.8 (1.6–9.1)). Our study provides further evidence that rare germline pathogenic variants in these genes are associated with increased risk of this aggressive, clinically relevant subset of PrCa. These rare genetic variants could be incorporated into risk prediction models to improve their precision to identify men at highest risk of aggressive prostate cancer and be used to identify men with newly diagnosed prostate cancer who require urgent treatment.


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