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- Title
Development and validation of a risk score for the prediction of cardiovascular disease in living donor kidney transplant recipients.
- Authors
Ueki, Kenji; Tsuchimoto, Akihiro; Matsukuma, Yuta; Nakagawa, Kaneyasu; Tsujikawa, Hiroaki; Masutani, Kosuke; Tanaka, Shigeru; Kaku, Keizo; Noguchi, Hiroshi; Okabe, Yasuhiro; Unagami, Kohei; Kakuta, Yoichi; Okumi, Masayoshi; Nakamura, Masafumi; Tsuruya, Kazuhiko; Nakano, Toshiaki; Tanabe, Kazunari; Kitazono, Takanari; investigators, Japan Academic Consortium of Kidney Transplantation
- Abstract
Background Cardiovascular disease (CVD) is a major cause of death in kidney transplant (KT) recipients. To improve their long-term survival, it is clinically important to estimate the risk of CVD after living donor KT via adequate pre-transplant CVD screening. Methods A derivation cohort containing 331 KT recipients underwent living donor KT at Kyushu University Hospital from January 2006 to December 2012. A prediction model was retrospectively developed and risk scores were investigated via a Cox proportional hazards regression model. The discrimination and calibration capacities of the prediction model were estimated via the c-statistic and the Hosmer–Lemeshow goodness of fit test. External validation was estimated via the same statistical methods by applying the model to a validation cohort of 300 KT recipients who underwent living donor KT at Tokyo Women's Medical University Hospital. Results In the derivation cohort, 28 patients (8.5%) had CVD events during the observation period. Recipient age, CVD history, diabetic nephropathy, dialysis vintage, serum albumin and proteinuria at 12 months after KT were significant predictors of CVD. A prediction model consisting of integer risk scores demonstrated good discrimination (c-statistic 0.88) and goodness of fit (Hosmer–Lemeshow test P = 0.18). In a validation cohort, the model demonstrated moderate discrimination (c-statistic 0.77) and goodness of fit (Hosmer–Lemeshow test P = 0.15), suggesting external validity. Conclusions The above-described simple model for predicting CVD after living donor KT was accurate and useful in clinical situations.
- Subjects
KIDNEY transplantation; PROPORTIONAL hazards models; CARDIOVASCULAR diseases; GOODNESS-of-fit tests; DIABETIC nephropathies
- Publication
Nephrology Dialysis Transplantation, 2021, Vol 36, Issue 2, p365
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfaa275