Evidence map›Paper›PMID 40613012›Full record

ArticleKidney medicine2025

Predicting Hospitalization and Related Outcomes in Advanced Chronic Kidney Disease: A Systematic Review, External Validation, and Development Study.

Roemer J Janse, Jet Milders, Joris I Rotmans, Fergus J Caskey, Marie Evans, Claudia Torino, Maciej Szymczak, Christiane Drechsler, Christoph Wanner, Maria Pippias and 7 more

Abstract read
In one paragraph

Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Roemer J JanseDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
Jet MildersDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
Joris I RotmansDepartment of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.
Fergus J CaskeyPopulation Health Sciences, Bristol Medical School, University of Bristol, United Kingdom.
Marie EvansRenal Unit, Department of Clinical Intervention and Technology (CLINTEC), Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Claudia TorinoIFC-CNR, Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
Maciej SzymczakDepartment of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Christiane DrechslerDivision of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
Christoph WannerDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital of Würzburg, Würzburg, Germany.
Maria PippiasPopulation Health Sciences, Bristol Medical School, University of Bristol, United Kingdom.
Antonio VilasiIFC-CNR, Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy.
Vianda S StelERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, the Netherlands.
Nicholas C ChesnayeERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, the Netherlands.
Kitty J JagerERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, the Netherlands.
Friedo W DekkerDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
Merel van DiepenDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
EQUAL study investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rationale & Objective: Hospitalization is common in patients with advanced chronic kidney disease (CKD). Predicting hospitalization and related outcomes would be beneficial for hospitals and patients. Therefore, we aimed to (1) give an overview of current prediction models for hospitalization, length of stay, and readmission in patients with advanced CKD; (2) externally validate these models; and (3) develop a new model if no valid models were identified. Study Design: Systematic review, development, and external validation study. Setting & Participants: We were interested in prediction models of hospitalization, length of stay, or readmission for patients with advanced CKD. Our available development and validation data consisted of hemodialysis, peritoneal dialysis, and advanced CKD patients not receiving dialysis from a Dutch dialysis and European advanced CKD cohort. Selection Criteria for Studies: We systematically searched PubMed. Studies had to intentionally develop, validate, or update a prediction model in adults with CKD. Analytical Approach: We used the PROBAST for risk of bias assessment. Identified models were externally validated on model discrimination (C-statistic) and calibration (calibration plot, slope, and calibration-in-the-large). We developed a Fine-Gray model for hospitalization within 1 year in patients initiating hemodialysis, accounting for the competing risk of death. Results: We identified 45 models in 8 studies. The majority were of low quality with a high risk of bias. Due to underreporting and population-specific predictors, we could only validate 3 models. These were poorly calibrated and had poor discrimination. Using multiple modeling strategies, an adequate new model could not be developed. Limitations: The outcome hospitalization might be too heterogeneous, and we did not have all relevant predictors available. Conclusions: Hospitalizations are important but difficult to predict for patients with advanced CKD. An improved prediction model should be developed, for example, using a more specific outcome (eg, cardiovascular hospitalizations) and more predictors (eg, patient-reported outcome measures).

Indexed as

Algorithmchronic kidney diseasedialysishospital admissionhospitalizationlength of staypredictionreadmissionrisk score

Identifiers

PMID40613012
PMCPMC12221738

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.