Prediction of ESRD and death among people with CKD: the Chronic Renal Impairment in Birmingham (CRIB) prospective cohort study.
Bottom Line: For death, age, N-terminal pro-brain natriuretic peptide, troponin T level, and cigarette smoking remained strongly predictive of risk.Other important factors may have been missed because of limited study power.Larger cohort studies are required to further validate these results.
Affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. email@example.comShow MeSH
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Mentions: Within the East Kent cohort of 213 patients with CKD stages 3-5 (not on renal replacement therapy), baseline characteristics were broadly similar to those in the CRIB Study (see Table S3). Prediction equations derived from the CRIB cohort were assessed independently for discrimination and calibration in the East Kent cohort (because urinary albumin-creatinine ratio was not measured in the East Kent cohort, all participants were assigned an arbitrary value of 350 mg/g). Even without knowledge of ACR, there was clear separation in risk over time between people at low, medium, and high risk of each outcome (Fig 3A), and the AUROC (the C statistic) was very good for both ESRD (0.91; 95% CI, 0.87-0.96) and death (0.82; 95% CI, 0.75-0.89; Fig 3B). When participants in the East Kent cohort were separated into 5 groups based on predicted risks of each outcome, observed annual event rates were systematically lower than predicted rates for ESRD, but reasonably well matched for mortality (Fig 3C). Virtually identical estimates of discrimination and calibration of ESRD risk were obtained when prediction equations that allowed the RR for creatinine level to vary during follow-up were used.
Affiliation: Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK. firstname.lastname@example.org