Floege J, Gillespie IA, Kronenberg F, Anker SD, Gioni I, Richards S, Pisoni RL, Robinson BM, Marcelli D, Froissart M, Eckardt KU (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 87
Pages Range: 996-1008
Journal Issue: 5
DOI: 10.1038/ki.2014.419
Although mortality risk scores for chronic hemodialysis (HD) patients should have an important role in clinical decision-making, those currently available have limited applicability, robustness, and generalizability. Here we applied a modified Framingham Heart Study approach to derive 1- and 2-year all-cause mortality risk scores using a 11,508 European incident HD patient database (AROii) recruited between 2007 and 2009. This scoring model was validated externally using similar-sized Dialysis Outcomes and Practice Patterns Survey (DOPPS) data. For AROii, the observed 1- and 2-year mortality rates were 13.0 (95% confidence interval (CI; 12.3-13.8)) and 11.2 (10.4-12.1)/100 patient years, respectively. Increasing age, low body mass index, history of cardiovascular disease or cancer, and use of a vascular access catheter during baseline were consistent predictors of mortality. Among baseline laboratory markers, hemoglobin, ferritin, C-reactive protein, serum albumin, and creatinine predicted death within 1 and 2 years. When applied to the DOPPS population, the predictive risk score models were highly discriminatory, and generalizability remained high when restricted by incidence/prevalence and geographic location (C-statistics 0.68-0.79). This new model offers improved predictive power over age/comorbidity-based models and also predicted early mortality (C-statistic 0.71). Our new model delivers a robust and reproducible mortality risk score, based on readily available clinical and laboratory data.
APA:
Floege, J., Gillespie, I.A., Kronenberg, F., Anker, S.D., Gioni, I., Richards, S.,... Eckardt, K.-U. (2015). Development and validation of a predictive mortality risk score from a European hemodialysis cohort. Kidney International, 87(5), 996-1008. https://doi.org/10.1038/ki.2014.419
MLA:
Floege, Juergen, et al. "Development and validation of a predictive mortality risk score from a European hemodialysis cohort." Kidney International 87.5 (2015): 996-1008.
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