作者
Gayathri Menon, Christopher B Pierce, Derek K Ng, Sahar Fathallah-Shaykh, Anjali Nayak, Martin Turman, Tom Blydt-Hansen, Cynthia Wong, Steve Alexander, Ora Yadin, Elizabeth Ingulli, Robert Mak, Cheryl Sanchez-Kazi, Asha Moudgil, Samina Muneeruddin, Carolyn Abitbol, Marissa DeFrietas, Chryso Katsoufis, Wacharee Seeherunvong, Larry Greenbaum, Lyndsay Harshman, Priya Verghese, Sonia Krishnan, Amy Wilson, Stefan Kiessling, Siddharth Shah, Janice Sullivan, Sushil Gupta, Samir El-Dahr, Stacy Drury, Nancy Rodig, Allison Dart, Meredith Atkinson, Arlene Gerson, Tej Matoo, Zubin Modi, Jason Thomas, Bradley Warady, Rebecca Johnson, Vikas Dharnidharka, Stephen Hooper, Susan Massengill, Liliana Gomez-Mendez, Matthew Hand, Joann Carlson, Craig Wong, Frederick Kaskel, Shlomo Shinnar, Jeffrey Saland, Marc Lande, George Schwartz, Anil Mongia, Donna Claes, Mark Mitsnefes, Katherine Dell, Hiren Patel, Pascale Lane, Rulan Parekh, Lisa Robinson, Amira Al-Uzri, Kelsey Richardson, Susan Furth, Larry Copelovitch, Elaine Ku, Joshua Samuels, Poyyapakkam Srivaths, Samhar Al-Akash, Davoud Mohtat, Victoria Norwood, Joseph Flynn, Cynthia Pan, Sharon Bartosh
发表日期
2023/6/1
期刊
American Journal of Kidney Diseases
卷号
81
期号
6
页码范围
734-737
出版商
WB Saunders
简介
The Kidney Failure Risk Equation (KFRE) is a widely validated equation to predict endstage kidney disease (ESKD) for adults with mild-to-moderate chronic kidney disease (CKD), developed in a geriatric cohort. 1 The KFRE was applied to the Chronic Kidney Disease in Children (CKiD) cohort, yielded good discrimination2, and was recommended for pediatric practice3, despite heterogeneous CKD etiologies and progression in children. This analysis only presented limited assessment of calibration, which is the other metric, along with discrimination, necessary for instrument validation, and this deserves particular attention in the application of an adult instrument for children.
While discrimination summarizes the ability of the prognostic test to ascribe a higher risk score to those with the event compared to those without the event, calibration refers to the congruency between predicted and observed risk. Calibration performance is often underreported4 and poorly calibrated instruments, even with good discrimination, can misinform and negatively impact decision-making5. To quantify calibration of the KFRE in children with CKD, we used a formal statistical test (Greenwood Nam-D’Agostino (GND) goodness-of-fit6) in CKiD data enhanced by additional follow-up and observed ESKD events. CKiD is a North American longitudinal cohort of children with CKD with a primary endpoint of ESKD, defined as kidney transplant or dialysis. We replicated the analytic structure in which the KFRE was first assessed2, with an additional 214 participants, extended follow-up, and estimation of albuminuria using pediatric-based equations7 (also see Item S1). The …
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G Menon, CB Pierce, DK Ng, S Fathallah-Shaykh… - American Journal of Kidney Diseases, 2023