ArticleJournal of nephrology2024
External validation of the KFRE and Grams prediction models for kidney failure and death in a Spanish cohort of patients with advanced chronic kidney disease.
Article in Journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 15 citations in OpenAlex.
- Nationwide Implementation of a Digital Health Module for Chronic Kidney Disease Screening: A RE-AIM Evaluation in Peru's Social Health System.Medical sciences (Basel, Switzerland) · 2026Article
- Planning of kidney replacement therapy in advanced CKD using the KFRE formula in a Spanish multicenter cohort.Clinical kidney journal · 2026Article
- External validation, recalibration, and clinical utility of the kidney failure risk equation in patients with advanced CKD: a nationwide retrospective cohort analysis in Peru.BMC nephrology · 2025Article
- Risk of Progression and Costs of Care for Patients with Type 2 Diabetes and Chronic Kidney Disease.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Adding biomarker change information to the kidney failure risk equation improves predictive ability for dialysis dependency in eGFR <30 ml/min/1.73 mClinical kidney journal · 2024Article
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7 authors at 2 institutions in 1 country.
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Abstract
backgroundThe Kidney Failure Risk Equation (KFRE) is a 2- and 5-year kidney failure prediction model that is applied in chronic kidney disease (CKD) G3 + . The Grams model predicts kidney failure and death at 2 and 4 years in CKD G4 + . There are limited external validations of the Grams model, especially for predicting mortality before kidney failure.
methodsWe performed an external validation of the Grams and Kidney Failure Risk Equation prediction models in incident patients with CKD G4 + at Hospital Universitario Fundación Alcorcón, Spain, between 1/1/2014 and 31/12/2018, ending follow-up on 30/09/2023. Discrimination was performed calculating the area under the receiver-operating characteristic curve. Calibration was assessed using the Hosmer-Lemeshow test and the Brier score.
resultsThe study included 339 patients (mean age 72.2 ± 12.7 years and baseline estimated glomerular filtration rate 20.6 ± 5.0 ml/min). Both models showed excellent discrimination. The area under the curve (AUC) for Kidney Failure Risk Equation-2 and Grams-2 were 0.894 (95% CI 0.857-0.931) and 0.897 (95%CI 0.859-0.935), respectively. For Grams-4 the AUC was 0.841 (95%CI 0.798-0.883), and for Kidney Failure Risk Equation-5 it was 0.823 (95% CI 0.779-0.867). For death before kidney failure, the Grams model showed acceptable discrimination (AUC 0.708 (95% CI 0.626-0.790) and 0.744 (95% CI 0.683-0.804) for Grams-2 and Grams-4, respectively). Both models presented excellent calibration for predicting kidney failure. Grams model calibration to estimate mortality before kidney failure was also excellent. In all cases, Hosmer-Lemeshow test resulted in a p-value greater than 0.05, and the Brier score was less than 0.20.
conclusionsIn a cohort of patients with CKD G4 + from southern Europe, both the Grams and Kidney Failure Risk Equation models are accurate in estimating the risk of kidney failure. Additionally, the Grams model provides a reliable estimate of the risk of mortality before kidney failure.
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