Performance of an easy-to-use prediction model for renal patient survival: an external validation study using data from the ERA-EDTA Registry.

Autor:	Hemke AC; Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.; Dutch Renal Replacement Registry, Leiden, The Netherlands., Heemskerk MBA; Dutch Renal Replacement Registry, Leiden, The Netherlands., van Diepen M; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands., Kramer A; ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., de Meester J; Department of Nephrology, Dialysis, and Hypertension, AZ Nikolaas, Sint-Niklaas, Belgium., Heaf JG; Department of Medicine, Zealand University Hospital, Roskilde, Denmark., Abad Diez JM; Aragon Renal Registry, Planning Department, Aragon Health Service, Spain., Torres Guinea M; Department of Nephrology, Hospital Virgen de La Salud, Toledo, Spain., Finne P; Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Finnish Registry for Kidney Diseases, Helsinki, Finland., Brunet P; Centre de Nephrologie et Transplantation Renale, Hospital de la Conception, Aix Marseille Université, AP-HM, Marseille, France., Vikse BE; Department of Medicine, Haugesund Hospital, Haugesund, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway., Caskey FJ; UK Renal Registry, Southmead Hospital, Bristol, UK.; School of Social and Community Medicine, University of Bristol, Bristol, UK., Traynor JP; Scottish Renal Registry, Information Services Division Scotland, Glasgow, UK., Massy ZA; Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.; Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, Paris, France., Couchoud C; Renal Epidemiology and Information Network (REIN) Registry, French Biomedical Agency, Saint-Denis-la-Plaine, France., Groothoff JW; Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands., Nordio M; Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.; Nephrology and Dialysis Unit, AULSS 6, Padua, Italy., Jager KJ; ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands., Dekker FW; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands., Hoitsma AJ; Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.; Division of Nephrology, University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2018 Oct 01; Vol. 33 (10), pp. 1786-1793.
DOI:	10.1093/ndt/gfx348
Abstrakt:	Background: An easy-to-use prediction model for long-term renal patient survival based on only four predictors [age, primary renal disease, sex and therapy at 90 days after the start of renal replacement therapy (RRT)] has been developed in The Netherlands. To assess the usability of this model for use in Europe, we externally validated the model in 10 European countries. Methods: Data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry were used. Ten countries that reported individual patient data to the registry on patients starting RRT in the period 1995-2005 were included. Patients <16  years of age and/or with missing predictor variable data were excluded. The external validation of the prediction model was evaluated for the 10- (primary endpoint), 5- and 3-year survival predictions by assessing the calibration and discrimination outcomes. Results: We used a data set of 136 304 patients from 10 countries. The calibration in the large and calibration plots for 10 deciles of predicted survival probabilities showed average differences of 1.5, 3.2 and 3.4% in observed versus predicted 10-, 5- and 3-year survival, with some small variation on the country level. The concordance index, indicating the discriminatory power of the model, was 0.71 in the complete ERA-EDTA Registry cohort and varied according to country level between 0.70 and 0.75. Conclusions: A prediction model for long-term renal patient survival developed in a single country, based on only four easily available variables, has a comparably adequate performance in a wide range of other European countries.
Databáze:	MEDLINE
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