A simple tool to predict end-stage renal disease within 1 year in elderly adults with advanced chronic kidney disease

Abstract

Objectives To develop and validate a model to predict 1-year risk of end-stage renal disease (ESRD) in elderly subjects with advanced chronic kidney disease (CKD). Design Retrospective. Setting Veterans Affairs Medical Center. Participants Individuals aged 65 and older with CKD with an estimated glomerular filtration rate (eGFR) less than 30 mL/min per 1.73 m2. Measurements The outcome was ESRD within 1 year of the index eGFR. Cox regression was used to develop a predictive model (Veterans Affairs (VA) risk score) that was validated in a separate cohort. Results Of the 1,866 participants in the developmental cohort, 77 developed ESRD. Risk factors for ESRD in the final model were age, congestive heart failure, systolic blood pressure, eGFR, potassium, and albumin. In the validation cohort, the C index for the VA risk score was 0.823. The risk for developing ESRD at 1 year from lowest to highest tertile was 0.08%, 2.7%, and 11.3% (P