New Model Helps Predict ESRD Onset

by U.S. Medicine

November 6, 2013

MINNEAPOLIS — A newly-developed risk model can be used to predict the occurrence of end-stage renal disease (ESRD) and appropriately prepare for renal replacement therapy in veterans with advanced chronic kidney disease, according to a new study.

“A new model using commonly available clinical measures shows excellent ability to predict the onset of ESRD within the next year in elderly adults,” write the authors of the report, published in the Journal of the American Geriatrics Society. The new Tangri model also had good predictive ability, they note.

The results stemmed from University of Minnesota researchers’ efforts to develop and validate a model to predict one-year risk of ESRD in elderly patients with advanced CKD.

Study participants were VA patients 65 and older with CKD with an estimated glomerular filtration rate (eGFR) less than 30 mL/min per 1.73 m(2). The outcome was defined as development of ESRD within one year of the index eGFR.

Researchers found that, of the 1,866 participants in the developmental cohort, 77 developed ESRD. Older age, congestive heart failure, systolic blood pressure as well as the results of several measurements, including eGFR, potassium, and albumin, were determined to be risk factors for ESRD.

“In the validation cohort, the C index for the VA risk score was 0.823. The risk for developing ESRD at one year from lowest to highest tertile was 0.08%, 2.7%, and 11.3% (P < .001). The C-index for the recently published Tangri model in the validation cohort was 0.780,” the authors conclude.

  1. Drawz PE, Goswami P, Azem R, Babineau DC, Rahman M. A simple tool to predict end-stage renal disease within 1 year in elderly adults with advanced chronic kidney disease. J Am Geriatr Soc. 2013 May;61(5):762-8. doi: 10.1111/jgs.12223. Epub 2013 Apr 25. PubMed PMID: 23617782; PubMed Central PMCID: PMC3711593.

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