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1. Predicting Kidney Failure, Cardiovascular Disease and Death in Advanced CKD Patients

Author

Cupisti, Adamasco, Sagliocca, Adelia, Ferraro, Alberto, Musiała, Aleksandra, Mele, Alessandra, Naticchia, Alessandro, Còsaro, Alex, Woodman, Alistair, Ranghino, Andrea, Stucchi, Andrea, Jonsson, Andreas, Schneider, Andreas, Pignataro, Angelo, Schrander, Anita, Torp, Anke, McKeever, Anna, Szymczak, Anna, Blom, Anna-Lena, De Blasio, Antonella, Pani, Antonello, Tsalouichos, Aris, Ullah, Asad, McLaren, Barbara, van Dam, Bastiaan, Iwig, Beate, Antonio, Bellasi, Di Iorio, Biagio Raffaele, Rogland, Björn, Perras, Boris, Alessandra, Butti, Harron, Camille, Wallquist, Carin, Siegert, Carl, Barrett, Carla, Gaillard, Carlo, Garofalo, Carlo, Abaterusso, Cataldo, Beerenhout, Charles, O'Toole, Charlotte, Somma, Chiara, Marx, Christian, Summersgill, Christina, Blaser, Christof, D'alessandro, Claudia, Emde, Claudia, Zullo, Claudia, Pozzi, Claudio, Geddes, Colin, Verburgh, Cornelis, Bergamo, Daniela, Ciurlino, Daniele, Motta, Daria, Glowski, Deborah, McGlynn, Deborah, Vargas, Denes, Krieter, Detlef, Russo, Domenico, Fuchs, Dunja, Sands, Dympna, Hoogeveen, Ellen, Irmler, Ellen, Dimény, Emöke, Favaro, Enrico, Platen, Eva, Olczyk, Ewelina, Hoorn, Ewout, Vigotti, Federica, Ansali, Ferruccio, Conte, Ferruccio, Cianciotta, Francesca, Giacchino, Francesca, Cappellaio, Francesco, Pizzarelli, Francesco, Sundelin, Fredrik, Uhlin, Fredrik, Greco, Gaetano, Roy, Geena, Porto, Gaetana, Bigatti, Giada, Marinangeli, Giancarlo, Cabiddu, Gianfranca, Hirst, Gillian, Fumagalli, Giordano, Caloro, Giorgia, Piccoli, Giorgina, Capasso, Giovanbattista, Gambaro, Giovanni, Tognarelli, Giuliana, Bonforte, Giuseppe, Conte, Giuseppe, Toscano, Giuseppe, Del Rosso, Goffredo, Welander, Gunilla, Augustyniak-Bartosik, Hanna, Boots, Hans, Schmidt-Gürtler, Hans, King, Hayley, McNally, Helen, Schlee, Hendrik, Boom, Henk, Naujoks, Holger, Masri-Senghor, Houda, Murtagh, Hugh, Rayner, Hugh, Miśkowiec-Wiśniewska, Ilona, Schlee, Ines, Capizzi, Irene, Hernandez, Isabel Bascaran, Baragetti, Ivano, Manitius, Jacek, Turner, Jane, Eijgenraam, Jan-Willem, Kooman, Jeroen, Beige, Joachim, Pondel, Joanna, Wilcox, Joanne, Berdeprado, Jocelyn, Röthele, Jochen, Wong, Jonathan, Rotmans, Joris, Banda, Joyce, Mazur, Justyna, Hahn, Kai, Jędrzejak, Kamila, Nowańska, Katarzyna, Blouin, Katja, Neumeier, Katrin, Jones, Kirsteen, Anding-Rost, Kirsten, Gröntoft, Knut-Christian, Oldrizzi, Lamberto, Haydock, Lesley, Vogt, Liffert, Wilkinson, Lily, Gesualdo, Loreto, Schramm, Lothar, Biancone, Luigi, Nowak, Łukasz, Raasveld, Maarten, Durlik, Magdalena, Magnano, Manuela, Vervloet, Marc, Ricardi, Marco, Carmody, Margaret, Di Bari, Maria, Laudato, Maria, Sirico, Maria Luisa, Stendahl, Maria, Svensson, Maria, Weetman, Maria, van Buren, Marjolijn, Joinson, Martin, Ferraresi, Martina, Dutton, Mary, van Diepen, Merel, Matthews, Michael, Provenzano, Michele, Hopf, Monika, Malaguti, Moreno, Wuttke, Nadja, Morgan, Neal, Palmieri, Nicola, Frischmuth, Nikolaus, Bleakley, Nina, Murrone, Paola, Cockwell, Paul, Leurs, Paul, Roderick, Paul, Voskamp, Pauline, Kashioulis, Pavlos, Ichtiaris, Pawlos, Blankestijn, Peter, Kirste, Petra, Schulz, Petra, Mason, Phil, Kalra, Philip, Cirillo, Pietro, Dattolo, Pietro, Acampora, Pina, Sajith, Rincy, Nigro, Rita, Boero, Roberto, Scarpioni, Roberto, Sicoli, Rosa, Malandra, Rosella, Aign, Sabine, Cäsar, Sabine, van Esch, Sadie, Chapman, Sally, Biribauer, Sandra, Navjee, Santee, Crosbie, Sarah, Brown, Sharon, Tickle, Sheila, Manan, Sherin, Röser, Silke, Savoldi, Silvana, Bertoli, Silvio, Borrelli, Silvio, Boorsma, Siska, Heidenreich, Stefan, Melander, Stefan, Maxia, Stefania, Maffei, Stefano, Mangano, Stefano, Palm, Stephanie, Konings, Stijn, Mathavakkannan, Suresh, Schwedler, Susanne, Delrieux, Sylke, Renker, Sylvia, Schättel, Sylvia, Dorota, Szyszkowska, Cicchetti, Teresa, Nieszporek, Teresa, Stephan, Theresa, Schmiedeke, Thomas, Weinreich, Thomas, Leimbach, Til, Rappa, Tiziana, Almquist, Tora, Stövesand, Torsten, Bahner, Udo, Jensen, Ulrika, Palazzo, Valentina, De Simone, Walter, Seeger, Wolfgang, Kuan, Ying, Heleniak, Zbigniew, Aydin, Zeynep, Ramspek, Chava L., Boekee, Rosemarijn, Evans, Marie, Heimburger, Olof, Snead, Charlotte M., Caskey, Fergus J., Torino, Claudia, Szymczak, Maciej, Krajewska, Magdalena, Drechsler, Christiane, Wanner, Christoph, Chesnaye, Nicholas C., Jager, Kitty J., Dekker, Friedo W., Snoeijs, Maarten G.J., and Rotmans, Joris I.

Published
2022
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4. Contributors

Author

Albright, Robert C., Jr, Amerling, Richard, Angeli, Paolo, Angelotti, Maria Lucia, Antonelli, Massimo, Antoniotti, Riccardo, Arulkumaran, Nishkantha, Asfar, Pierre, Ash, Stephen R., Aucella, Filippo, Aucella, Francesco, Ave, Samuele, Bagshaw, Sean M., Balaraman, Vasanthi, Baldwin, Ian, Bargman, Joanne M., Barletta, Gina-Marie, Barletta, Jeffrey F., Barnela, Shriganesh R., Bayır, Hülya, Beaulieu, Monica, Bellasi, Antonio, Bellomo, Rinaldo, Beloncle, François, Bhansali, Arjun, Bihorac, Azra, Billings, Frederic T., IV, Birk, Horst-Walter, Bonilla-Reséndiz, Luis Ignacio, Bouchard, Josée, Bourke, Edmund, Braitberg, George, Brendolan, Alessandra, Brocca, Alessandra, Brophy, Patrick D., Bucala, Richard, Bunchman, Timothy E., Burdmann, Emmanuel A., Busse, Laurence W., Caires, Renato Antunes, Caironi, Pietro, Camilla, Roberta, Campos, Israel, Canaud, Bernard, Cantaluppi, Vincenzo, Martinez, Maria P., Capasso, Giovambattista, Carcillo, Joseph A., Carlesso, Eleonora, Dip., Casino, Francesco G., Castellano, Giuseppe, Catania, Matteo, Cawcutt, Kelly A., Cerda, Jorge, Charen, Elliot, Chawla, Lakhmir S., Chiaramonte, Stefano, Chua, Horng-Ruey, Cianciaruso, Bruno, Ciceri, Paola, Cieslak, Jacek, Clark, William R., Claure-Del Granado, Rolando, Clementi, Anna, Co, Ivan N., Coelho, Fernanda Oliveira, Conte, Ferruccio, Corey, Howard E., Cosmai, Laura, Costalonga, Elerson Carlos, Costamagna, Andrea, Costanzo, Maria Rosa, Cozzolino, Mario, Cramer, Carl H., II, Cravedi, Paolo, Crepaldi, Carlo, Creteur, Jacques, Crew, R. John, da Costa e Silva, Verônica Torres, Davenport, Andrew, Davies, Andrew R., D'Costa, Rohit, Dean, Dawson F., Debiais, Charlotte, de Cal, Massimo, Dedhia, Paras, de Grooth, Harm-Jan, Dell'Aquila, Roberto, Dellepiane, Sergio, Dellinger, Richard Phillip, Del Vecchio, Lucia, Depner, Thomas A., De Rosa, Silvia, Deutschman, Clifford S., Devarajan, Prasad, Dewitte, A., Di Iorio, Biagio R., Di Lullo, Luca, Di Micco, Lucia, Di Nardo, Matteo, Ding, Xiaoqiang, D'Ippoliti, Fiorella, Di Somma, Salvatore, Doi, Kent, Dries, David J., Druml, Wilfred, Duke, Graeme, Durand, Francois, Eadon, Michael T., Eckstein, Devin, Egi, Moritoki, Eiam-Ong, Somchai, Elbers, Paul W.G., Elli, Francesca, Elliott, Steve, Emlet, David R., Endre, Zoltan, Evans, Roger G., Fanelli, Vito, Fattahi, Fatemeh, Federspiel, Christine Kinggaard, Ferrada, Marcela A., Ferrari, Fiorenza, Fiaccadori, Enrico, Fiorentino, Marco, Fisher, Caleb, Flessner, Michael F., Formica, Marco, Forni, Lui G., Francoz, Claire, French, Craig, Fuhrman, Dana Y., Fumagalli, Giordano, Galbusera, Miriam, Gallieni, Maurizio, Gammill, Hilary S., Gao, Dayong, Garzotto, Francesco, Gatta, Giuseppe, Genga, Kelly R., Genovesi, Simonetta, Genyk, Yuri S., Geradin, Christel, Gesualdo, Loreto, Giavarina, Davide, Giuliani, Anna, Glezerman, Ilya G., Goldstein, Stuart L., Golper, Thomas A., Gómez, Hernando, Granata, Antonio, Grandaliano, Giuseppe, Grasselli, Giacomo, Groeneveld, A.B. Johan, Guerci, Philippe, Gunnerson, Kyle J., Harbord, Nikolas, Harshman, Lyndsay A., Hennessy, Anthony J., Hill, Graham L., Hobson, Charles, Hohenstein, Bernd, Honoré, Patrick M., Horwitz, Edward, Hosseinian, Leila, Hoste, Eric A.J., House, Andrew A., Humes, H. David, Husain-Syed, Faeq, Ince, Can, Ing, Todd S., Jacobs, Rita, Jaswal, Dharmvir, Jeyabalan, Arun, Joannes-Boyau, Olivier, Joannidis, Michael, Joyce, Emily, Kane-Gill, Sandra L., Kaplan, Lewis J., Kashani, Kianoush, Katz, Nevin, Kellum, John A., Khanna, Ramesh, Kim-Campbell, Nahmah, King, Joshua D., Kirwan, Christopher J., Kiss, Joseph E., Klein, David, Kotanko, Peter, Krediet, Raymond T., Kuhlmann, Martin K., Kuiper, Jan Willem, Lachance, Philippe, Lameire, Norbert, Langer, Thomas, Lankadeva, Yugeesh R., Laurin, Louis-Philippe, Lazzeri, Elena, Leblanc, Martine, Lefebvre, Joannie, Lentini, Paolo, Leray-Moragués, Hélène, Levin, Adeera, Lew, Susie Q., Liapis, Helen, Liu, Kathleen D., Livigni, Sergio, Locatelli, Francesco, Lorenzin, Anna, Lu, Jian-Da, Lu, Renhua, Lysak, Nicholas, Macedo, Etienne, Madan, Niti, Madore, François, Maerz, Linda L., Maiden, Matthew J., Malhotra, Rakesh, Marengo, Marita, Mariano, Filippo, Marik, Paul E., Marini, John J., Marino, Rossella, Marshall, Mark R., Mårtensson, Johan, Matsuura, Ryo, May, Clive N., Mazzone, Patrizio, McCauley, Jerry, McCullough, Peter A., McMahon, Blaithin A., Mehta, Ravindra L., Mele, Caterina, Menon, Madhav, Meola, Mario, Mérouani, Aicha, Meuwly, Jean-Yves, Milla, Paola, Misra, Madhukar, Misra, Paraish S., Mizock, Barry A., Modi, Jwalant R., Moeckel, Gilbert, Molitoris, Bruce A., Morabito, Santo, Mucelli, Roberto Pozzi, Murray, Patrick T., Murugan, Raghavan, Nadim, Mitra K., Nair, Devika, Nalesso, Federico, Neri, Mauro, Nguyen, Trung C., Ni, Zhaohui, Noris, Marina, Novick, Tessa, O'Horo, John C., Okusa, Mark Douglas, Opal, Steven M., Opdam, Helen Ingrid, Ostermann, Marlies, Ottaviano, Emerenziana, Oudemans-van Straaten, Heleen M., Overgaard-Steensen, Christian, Padalino, Massimo A., Panichi, Vincenzo, Parameswaran, Priyanka, Patel, Samir S., Payen, Didier, Pea, Federico, Peacock, W. Frank, Peart, Sandrica Young, Peerapornratana, Sadudee, Pelosi, Paolo, Peng, Zhi-Yong, Perico, Norberto, Peruzzi, Licia, Pesce, Francesco, Pesenti, Antonio, Petrucci, Ilaria, Pham, Phuong-Chi, Pham, Phuong-Thu, Phoon, Richard K.S., Piano, Salvatore, Pinsky, Michael R., Piquilloud, Lise, Pistolesi, Valentina, Plank, Lindsay D., Plötz, Frans B., Podestá, Manuel Alfredo, Porta, Camillo, Pozzato, Marco, Prencipe, Michele, Prowle, John R., Puthucheary, Zudin A., Qu, Lirong, Rachoin, Jean-Sebastien, Radhakrishnan, Jai, Ranieri, V. Marco, Ratanarat, Ranistha, Remuzzi, Giuseppe, Resnick, Shelby, Rewa, Oleksa G., Ricci, Zaccaria, Ridel, Christophe, Rifai, Kinan, Ring, Troels, Rizo-Topete, Lilia M., Roessler, Eric, Romagnani, Paola, Romagnoli, Stefano, Ronco, Claudio, Ronco, Federico, Rosner, Mitchell H., Rossetti, Emanuele, Russell, James A., Saab, Georges, Sabatino, Alice, Saboo, Sonali S., Samoni, Sara, Sappington, Penny Lynn, Sartori, Marco, Savige, Judy, Schena, Francesco Paolo, Schneider, Antoine Guillaume, Schraverus, Pieter, Schulte, Wibke, Segoloni, Giuseppe, Semler, Matthew W., Sharma, Aashish, Shaw, Andrew, Sheth, Naitik, Shukla, Ashutosh, Siddall, Eric C., Sievers, Theodore M., Siew, Edward D., Singbartl, Kai, Singer, Mervyn, Singh, Pooja, Smith, Loren E., Soni, Sachin S., Soto, Mara Serrano, Spapen, Herbert D., Srisawat, Nattachai, Srivastava, Ajay, Stellin, Giovanni, Symons, Jordan M., Szamosfalvi, Balazs, Tai, Kian Bun, Takalkar, Unmesh V., Teitelbaum, Isaac, Tetta, Ciro, Thakar, Charuhas V., Tonon, Marta, Trepiccione, Francesco, Triulzi, Darrell, Tushar, Chopra, Uchino, Shigehiko, Valika, Ali, Van Biesen, Wim, Vandenberghe, Wim, Vanholder, Raymond, Vanmassenhove, Jill, Verbine, Anton, Vergano, Marco, Villa, Gianluca, Villeneuve, Pierre-Marc, Vincent, Jean-Louis, Vinsonneau, Christophe, Virzì, Grazia Maria, Visconti, Federico, Visvanathan, Ravindran, Van Vong, Li, Walmrath, Hans-Dieter, Ward, Peter A., Weir, Matthew A., Wen, Xiaoyan, Wendon, Julia, Winchester, James Frank, Wong, Adrian, Woodhouse, Elke L., Xue, Jun, Yadav, Anju, Yerram, Preethi, Yessayan, Lenar, Yeun, Jane Y., Yu, Alex W., Zaccaria, Marta, Zacchia, Miriam, Zachariah, Teena P., Zamperetti, Nereo, Zampieri, Fernando G., Zanco, Pierluigi, Zanella, Alberto, Zanoli, Luca, Zappitelli, Michael, Zaragoza, Jose J., Zarbock, Alexander, Zaroccolo, Marta, Zhang, Han, and Zimmer, Andrea

Published
2019
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5. Outcomes of Vascular Access Care and Surgery Managed by Interventional Nephrologists: A Twelve-Year Experience.

Author

Fumagalli, Giordano, De Pietro, Stefano, Migliori, Massimiliano, Ferrandello, Francesco Paolo, Trovato, Fabio, Donadio, Carlo, and Panichi, Vincenzo

Subjects
*ARTERIOVENOUS fistula, *BLOOD-vessel abnormalities, *HEALTH outcome assessment, *INTERVENTIONAL radiology, *NEPHROLOGISTS, *CATHETERS, *THERAPEUTICS
Abstract

Background: Optimizing vascular access outcomes is still a challenge, since 30-60% of arteriovenous fistulas fail or do not mature and catheters are widely used in contemporary patients. Methods: This study reports on strategies and outcomes in a single center in which access planning, surgery and maintenance are managed by a team of nephrologists. We retrospectively analyzed 305 fistulas and 61 grafts created in 270 consecutive patients between 2002 and 2013. Results: The percentage of patients receiving a fistula or graft who initiated hemodialysis with a mature access was 68.6%. Among prevalent patients, 71.7% used a fistula, 15.7% a graft and 12.6% a catheter. Rates of primary failure and revision before cannulation were 14.4 and 1.6% for fistulas vs. 4.9 and 3.3% for grafts. After maturation, complications (1.040 vs. 0.188 per patient-year (py)) and interventions (0.743 vs. 0.066 per py) were greater for grafts than for fistulas (p < 0.001). Secondary patency did not significantly differ between grafts and fistulas (median survival 34.8 vs. 57.3 months, p = 0.36), unless primary failures were excluded from Kaplan-Meier analysis (median survival 34.9 vs. 70.9 months, p = 0.03). Conclusions: High fistula prevalence, low access-related morbidity and catheter dependence were achieved using individualized strategies, including midforearm or perforating vein fistula creation and selective graft placement in high risk patients. Direct involvement of nephrologists throughout all steps of access care can improve access outcomes, by promoting a patient-centered approach. [ABSTRACT FROM AUTHOR]

Published
2016
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6. Nutrition and Physical Activity in CKD patients.

Author

Cupisti, Adamasco, D'Alessandro, Claudia, Fumagalli, Giordano, Vigo, Valentina, Meola, Mario, Cianchi, Caterina, and Egidi, Maria F.

Subjects
NUTRITION research, CHRONIC kidney failure, PHYSICAL activity, KIDNEY diseases, HEMODIALYSIS
Abstract

Chronic kidney disease (CKD) patients are at risk for protein-energy wasting, abnormal body composition and impaired physical capacity. These complications lead to increased risk of hospitalization, morbidity and mortality.In CKD patient as well as in healthy people, there is a close association between nutrition and physical activity. Namely, inadequate nutrient (energy) intake impairs physical performance thus favoring a sedentary lifestyle: this further contributes to loss of muscle strength and mass, which limit the quality of life and rehabilitation of CKD patients. In CKD as well as in end-stage-renal-disease patients, regular physical activity coupled with adequate energy and protein intake counteracts protein-energy wasting and related comorbidity and mortality. In summary, exercise training can positively influence nutritional status and the perception of well-being of CKD patients and may facilitate the anabolic effects of nutritional interventions. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2014
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7. The forearm arteriovenous graft between the brachial artery and the brachial vein as a reliable dialysis vascular access for patients with inadequate superficial veins.

Author

Fumagalli, Giordano, Trovato, Fabio, Migliori, Massimiliano, Panichi, Vincenzo, and De Pietro, Stefano

Abstract

The arteriovenous fistula (AVF) is recommended as the preferred hemodialysis access. However, placing an AVF in all patients may result in poor access outcomes and increased central venous catheter (CVC) use because of increased comorbid conditions, age, and suboptimal vessels. In patients with inadequate superficial veins for AVFs, the use of the brachial veins for creation of forearm arteriovenous grafts (AVGs) has received limited attention. This retrospective study aimed to evaluate outcomes of forearm brachial-brachial AVGs (BB-AVGs) placed in patients with poor superficial veins. We identified 111 BB-AVGs created in 111 consecutive patients, using standard-walled polytetrafluoroethylene grafts, between January 2010 and December 2015. After excluding 6 patients (non-dialysis initiation, missing information, and death within 1 month), we included 105 patients from 21 dialysis centers. We analyzed primary failures, time to cannulation, patency, complications, and revisions. Patency rates were calculated by the Kaplan-Meier method. The incidence of complications and revisions was expressed as number of events per person-year. A total of 105 patients (median age, 69 years) were followed up for a median time of 21.2 months (interquartile range, 9.2-36.5 months). Of the patients, 72.4% were on chronic hemodialysis and had previously undergone one or more access procedures. At the time of BB-AVG placement, prior accesses were 39 AVFs, 20 tunneled CVCs, and 17 AVGs. BB-AVG rates of primary failure and revision before cannulation were 7.6% and 5.7%, respectively. BB-AVGs were cannulated after a median time of 3.4 weeks (interquartile range, 2.8-4.1 weeks). Primary patency rates at 12, 24, and 36 months were 49.5%, 29.5%, and 19.5%. Secondary patency rates at 12, 24, and 36 months were 76.3%, 62.7%, and 54.6%. After cannulation, the incidence of complications and revisions was 1.054 and 0.649 per person-year, respectively. Most complications and interventions were due to thrombosis (0.527 per person-year) or stenosis (0.381 per person-year) and related interventions (0.490 per person-year). A minority of patients experienced AVG infections (0.052 per person-year), with only two requiring access removal. In patients with poor superficial veins, the forearm BB-AVG is a reliable access because of low access-related morbidity and considerable long-term access survival. BB-AVG placement has the advantage of preserving proximal vessels. In these patients, such an approach can delay both rapid exhaustion of vascular sites and early recourse to CVC permanent use. [ABSTRACT FROM AUTHOR]

Published
2019
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8. Kidney failure prediction models

Author

Ramspek, Chava L, Evans, Marie, Wanner, Christoph, Drechsler, Christiane, Chesnaye, Nicholas C, Szymczak, Maciej, Krajewska, Magdalena, Torino, Claudia, Porto, Gaetana, Hayward, Samantha, Caskey, Fergus, Dekker, Friedo W, Jager, Kitty J, van Diepen, Merel, EQUAL Study Investigators: Adamasco Cupisti, Adelia Sagliocca, Alberto Ferraro, Aleksandra Musiała, Alessandra Mele, Alessandro Naticchia, Alex Còsaro, Alistair Woodman, Andrea Ranghino, Andrea Stucchi, Andreas Jonsson, Andreas Schneider, Angelo Pignataro, Anita Schrander, Anke Torp, Anna McKeever, Anna Szymczak, Anna-Lena Blom, Antonella De Blasio, Antonello Pani, Aris Tsalouichos, Asad Ullah, Barbara McLaren, Bastiaan van Dam, Beate Iwig, Bellasi Antonio, Biagio Raffaele Di Iorio, Björn Rogland, Boris Perras, Butti Alessandra, Camille Harron, Carin Wallquist, Carl Siegert, Carla Barrett, Carlo Gaillard, Carlo Garofalo, Cataldo Abaterusso, Charles Beerenhout, Charlotte O'Toole, Chiara Somma, Christian Marx, Christina Summersgill, Christof Blaser, Claudia D'alessandro, Claudia Emde, Claudia Zullo, Claudio Pozzi, Colin Geddes, Cornelis Verburgh, Daniela Bergamo, Daniele Ciurlino, Daria Motta, Deborah Glowski, Deborah McGlynn, Denes Vargas, Detlef Krieter, Domenico Russo, Dunja Fuchs, Dympna Sands, Ellen Hoogeveen, Ellen Irmler, Emöke Dimény, Enrico Favaro, Eva Platen, Ewelina Olczyk, Ewout Hoorn, Federica Vigotti, Ferruccio Ansali, Ferruccio Conte, Francesca Cianciotta, Francesca Giacchino, Francesco Cappellaio, Francesco Pizzarelli, Fredrik Sundelin, Fredrik Uhlin, Gaetano Greco, Geena Roy, Gaetana Porto, Giada Bigatti, Giancarlo Marinangeli, Gianfranca Cabiddu, Gillian Hirst, Giordano Fumagalli, Giorgia Caloro, Giorgina Piccoli, Giovanbattista Capasso, Giovanni Gambaro, Giuliana Tognarelli, Giuseppe Bonforte, Giuseppe Conte, Giuseppe Toscano, Goffredo Del Rosso, Gunilla Welander, Hanna Augustyniak-Bartosik, Hans Boots, Hans Schmidt-Gürtler, Hayley King, Helen McNally, Hendrik Schlee, Henk Boom, Holger Naujoks, Houda Masri-Senghor, Hugh Murtagh, Hugh Rayner, Ilona Miśkowiec-Wiśniewska, Ines Schlee, Irene Capizzi, Isabel Bascaran Hernandez, Ivano Baragetti, Jacek Manitius, Jane Turner, Jan-Willem Eijgenraam, Jeroen Kooman, Joachim Beige, Joanna Pondel, Joanne Wilcox, Jocelyn Berdeprado, Jochen Röthele, Jonathan Wong, Joris Rotmans, Joyce Banda, Justyna Mazur, Kai Hahn, Kamila Jędrzejak, Katarzyna Nowańska, Katja Blouin, Katrin Neumeier, Kirsteen Jones, Kirsten Anding-Rost, Knut-Christian Gröntoft, Lamberto Oldrizzi, Lesley Haydock, Liffert Vogt, Lily Wilkinson, Loreto Gesualdo, Lothar Schramm, Luigi Biancone, Łukasz Nowak, Maarten Raasveld, Magdalena Durlik, Manuela Magnano, Marc Vervloet, Marco Ricardi, Margaret Carmody, Maria Di Bari, Maria Laudato, Maria Luisa Sirico, Maria Stendahl, Maria Svensson, Maria Weetman, Marjolijn van Buren, Martin Joinson, Martina Ferraresi, Mary Dutton, Merel van Diepen, Michael Matthews, Michele Provenzano, Monika Hopf, Moreno Malaguti, Nadja Wuttke, Neal Morgan, Nicola Palmieri, Nikolaus Frischmuth, Nina Bleakley, Paola Murrone, Paul Cockwell, Paul Leurs, Paul Roderick, Pauline Voskamp, Pavlos Kashioulis, Pawlos Ichtiaris, Peter Blankestijn, Petra Kirste, Petra Schulz, Phil Mason, Philip Kalra, Pietro Cirillo, Pietro Dattolo, Pina Acampora, Rincy Sajith, Rita Nigro, Roberto Boero, Roberto Scarpioni, Rosa Sicoli, Rosella Malandra, Sabine Aign, Sabine Cäsar, Sadie van Esch, Sally Chapman, Sandra Biribauer, Santee Navjee, Sarah Crosbie, Sharon Brown, Sheila Tickle, Sherin Manan, Silke Röser, Silvana Savoldi, Silvio Bertoli, Silvio Borrelli, Siska Boorsma, Stefan Heidenreich, Stefan Melander, Stefania Maxia, Stefano Maffei, Stefano Mangano, Stephanie Palm, Stijn Konings, Suresh Mathavakkannan, Susanne Schwedler, Sylke Delrieux, Sylvia Renker, Sylvia Schättel, Szyszkowska Dorota, Teresa Cicchetti, Teresa Nieszporek, Theresa Stephan, Thomas Schmiedeke, Thomas Weinreich, Til Leimbach, Tiziana Rappa, Tora Almquist, Torsten Stövesand, Udo Bahner, Ulrika Jensen, Valentina Palazzo, Walter De Simone, Wolfgang Seeger, Ying Kuan, Zbigniew Heleniak, Zeynep Aydin, Internal Medicine, Chava L, Ramspek, Marie, Evan, Christoph, Wanner, Christiane, Drechsler, Nicholas C, Chesnaye, Maciej, Szymczak, Magdalena, Krajewska, Claudia, Torino, Gaetana, Porto, Samantha, Hayward, Fergus, Caskey, Friedo W, Dekker, Kitty J, Jager, Merel, van Diepen, Study Investigators: Adamasco Cupisti, Equal, Sagliocca, Adelia, Ferraro, Alberto, Musiała, Aleksandra, Mele, Alessandra, Naticchia, Alessandro, Còsaro, Alex, Woodman, Alistair, Ranghino, Andrea, Stucchi, Andrea, Jonsson, Andrea, Schneider, Andrea, Pignataro, Angelo, Schrander, Anita, Torp, Anke, Mckeever, Anna, Szymczak, Anna, Blom, Anna-Lena, De Blasio, Antonella, Pani, Antonello, Tsalouichos, Ari, Ullah, Asad, Mclaren, Barbara, van Dam, Bastiaan, Iwig, Beate, Antonio, Bellasi, Raffaele Di Iorio, Biagio, Rogland, Björn, Perras, Bori, Alessandra, Butti, Harron, Camille, Wallquist, Carin, Siegert, Carl, Barrett, Carla, Gaillard, Carlo, Garofalo, Carlo, Abaterusso, Cataldo, Beerenhout, Charle, O'Toole, Charlotte, Somma, Chiara, Marx, Christian, Summersgill, Christina, Blaser, Christof, D'Alessandro, Claudia, Emde, Claudia, Zullo, Claudia, Pozzi, Claudio, Geddes, Colin, Verburgh, Corneli, Bergamo, Daniela, Ciurlino, Daniele, Motta, Daria, Glowski, Deborah, Mcglynn, Deborah, Vargas, Dene, Krieter, Detlef, Russo, Domenico, Fuchs, Dunja, Sands, Dympna, Hoogeveen, Ellen, Irmler, Ellen, Dimény, Emöke, Favaro, Enrico, Platen, Eva, Olczyk, Ewelina, Hoorn, Ewout, Vigotti, Federica, Ansali, Ferruccio, Conte, Ferruccio, Cianciotta, Francesca, Giacchino, Francesca, Cappellaio, Francesco, Pizzarelli, Francesco, Sundelin, Fredrik, Uhlin, Fredrik, Greco, Gaetano, Roy, Geena, Porto, Gaetana, Bigatti, Giada, Marinangeli, Giancarlo, Cabiddu, Gianfranca, Hirst, Gillian, Fumagalli, Giordano, Caloro, Giorgia, Piccoli, Giorgina, Capasso, Giovanbattista, Gambaro, Giovanni, Tognarelli, Giuliana, Bonforte, Giuseppe, Conte, Giuseppe, Toscano, Giuseppe, Del Rosso, Goffredo, Welander, Gunilla, Augustyniak-Bartosik, Hanna, Boots, Han, Schmidt-Gürtler, Han, King, Hayley, Mcnally, Helen, Schlee, Hendrik, Boom, Henk, Naujoks, Holger, Masri-Senghor, Houda, Murtagh, Hugh, Rayner, Hugh, Miśkowiec-Wiśniewska, Ilona, Schlee, Ine, Capizzi, Irene, Bascaran Hernandez, Isabel, Baragetti, Ivano, Manitius, Jacek, Turner, Jane, Eijgenraam, Jan-Willem, Kooman, Jeroen, Beige, Joachim, Pondel, Joanna, Wilcox, Joanne, Berdeprado, Jocelyn, Röthele, Jochen, Wong, Jonathan, Rotmans, Jori, Banda, Joyce, Mazur, Justyna, Hahn, Kai, Jędrzejak, Kamila, Nowańska, Katarzyna, Blouin, Katja, Neumeier, Katrin, Jones, Kirsteen, Anding-Rost, Kirsten, Gröntoft, Knut-Christian, Oldrizzi, Lamberto, Haydock, Lesley, Vogt, Liffert, Wilkinson, Lily, Gesualdo, Loreto, Schramm, Lothar, Biancone, Luigi, Nowak, Łukasz, Raasveld, Maarten, Durlik, Magdalena, Magnano, Manuela, Vervloet, Marc, Ricardi, Marco, Carmody, Margaret, Di Bari, Maria, Laudato, Maria, Luisa Sirico, Maria, Stendahl, Maria, Svensson, Maria, Weetman, Maria, van Buren, Marjolijn, Joinson, Martin, Ferraresi, Martina, Dutton, Mary, van Diepen, Merel, Matthews, Michael, Provenzano, Michele, Hopf, Monika, Malaguti, Moreno, Wuttke, Nadja, Morgan, Neal, Palmieri, Nicola, Frischmuth, Nikolau, Bleakley, Nina, Murrone, Paola, Cockwell, Paul, Leurs, Paul, Roderick, Paul, Voskamp, Pauline, Kashioulis, Pavlo, Ichtiaris, Pawlo, Blankestijn, Peter, Kirste, Petra, Schulz, Petra, Mason, Phil, Kalra, Philip, Cirillo, Pietro, Dattolo, Pietro, Acampora, Pina, Sajith, Rincy, Nigro, Rita, Boero, Roberto, Scarpioni, Roberto, Sicoli, Rosa, Malandra, Rosella, Aign, Sabine, Cäsar, Sabine, van Esch, Sadie, Chapman, Sally, Biribauer, Sandra, Navjee, Santee, Crosbie, Sarah, Brown, Sharon, Tickle, Sheila, Manan, Sherin, Röser, Silke, Savoldi, Silvana, Bertoli, Silvio, Borrelli, Silvio, Boorsma, Siska, Heidenreich, Stefan, Melander, Stefan, Maxia, Stefania, Maffei, Stefano, Mangano, Stefano, Palm, Stephanie, Konings, Stijn, Mathavakkannan, Suresh, Schwedler, Susanne, Delrieux, Sylke, Renker, Sylvia, Schättel, Sylvia, Dorota, Szyszkowska, Cicchetti, Teresa, Nieszporek, Teresa, Stephan, Theresa, Schmiedeke, Thoma, Weinreich, Thoma, Leimbach, Til, Rappa, Tiziana, Almquist, Tora, Stövesand, Torsten, Bahner, Udo, Jensen, Ulrika, Palazzo, Valentina, De Simone, Walter, Seeger, Wolfgang, Kuan, Ying, Heleniak, Zbigniew, Aydin, Zeynep, Medical Informatics, ACS - Pulmonary hypertension & thrombosis, APH - Aging & Later Life, APH - Health Behaviors & Chronic Diseases, APH - Methodology, APH - Quality of Care, and APH - Global Health

Subjects
Male, progression of chronic renal failure, medicine.medical_specialty, Time Factors, epidemiology and outcome, 030232 urology & nephrology, Risk Assessment, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Older patients, external validation, Predictive Value of Tests, medicine, Humans, Failure risk, Clinical Epidemiology, In patient, comprehensive external validation, 030212 general & internal medicine, Statistic, Aged, Aged, 80 and over, Kidney, Models, Statistical, business.industry, External validation, General Medicine, prediction, kidney failure, Europe, prediction model, medicine.anatomical_structure, chronic kidney disease, epidemiology and outcomes, prognosis, Nephrology, Emergency medicine, Disease Progression, Kidney Failure, Chronic, Female, business, prognostic, Predictive modelling, prognosi, Cohort study
Abstract

Background Various prediction models have been developed to predict the risk of kidney failure in patients with CKD. However, guideline-recommended models have yet to be compared head to head, their validation in patients with advanced CKD is lacking, and most do not account for competing risks. Methods To externally validate 11 existing models of kidney failure, taking the competing risk of death into account, we included patients with advanced CKD from two large cohorts: the European Quality Study (EQUAL), an ongoing European prospective, multicenter cohort study of older patients with advanced CKD, and the Swedish Renal Registry (SRR), an ongoing registry of nephrology-referred patients with CKD in Sweden. The outcome of the models was kidney failure (defined as RRT-treated ESKD). We assessed model performance with discrimination and calibration. Results The study included 1580 patients from EQUAL and 13,489 patients from SRR. The average c statistic over the 11 validated models was 0.74 in EQUAL and 0.80 in SRR, compared with 0.89 in previous validations. Most models with longer prediction horizons overestimated the risk of kidney failure considerably. The 5-year Kidney Failure Risk Equation (KFRE) overpredicted risk by 10%-\18%. The four- and eight-variable 2-year KFRE and the 4-year Grams model showed excellent calibration and good discrimination in both cohorts. Conclusions Some existing models can accurately predict kidney failure in patients with advanced CKD. KFRE performed well for a shorter time frame (2 years), despite not accounting for competing events. Models predicting over a longer time frame (5 years) overestimated risk because of the competing risk of death. The Grams model, which accounts for the latter, is suitable for longer-term predictions (4 years).

Published
2021
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