@article{d7008f906ae1489b9167441e28d39415,
title = "The kidney failure risk equation predicts kidney failure: Validation in an Australian cohort",
abstract = "Aims: Predicting progression to kidney failure for patients with chronic kidney disease is essential for patient and clinicians' management decisions, patient prognosis, and service planning. The Tangri et al Kidney Failure Risk Equation (KFRE) was developed to predict the outcome of kidney failure. The KFRE has not been independently validated in an Australian Cohort. Methods: Using data linkage of the Tasmanian Chronic Kidney Disease study (CKD.TASlink) and the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), we externally validated the KFRE. We validated the 4, 6, and 8-variable KFRE at both 2 and 5 years. We assessed model fit (goodness of fit), discrimination (Harell's C statistic), and calibration (observed vs predicted survival). Results: There were 18 170 in the cohort with 12 861 participants with 2 years and 8182 with 5 years outcomes. Of these 2607 people died and 285 progressed to kidney replacement therapy. The KFRE has excellent discrimination with C statistics of 0.96–0.98 at 2 years and 0.95–0.96 at 5 years. The calibration was adequate with well-performing Brier scores (0.004–0.01 at 2 years, 0.01–0.03 at 5 years) however the calibration curves, whilst adequate, indicate that predicted outcomes are systematically worse than observed. Conclusion: This external validation study demonstrates the KFRE performs well in an Australian population and can be used by clinicians and service planners for individualised risk prediction.",
keywords = "Australia, calibration, chronic, kidney, renal dialysis, renal insufficiency",
author = "Irish, {Georgina L.} and Laura Cuthbertson and Alex Kitsos and Tim Saunder and Clayton, {Philip A.} and Jose, {Matthew D.}",
note = "Funding Information: The authors would like to thank the following organisations; Diagnostic Services Pty Ltd and Pathology South for the provision of pathology data; the Department of Health, Tasmania for the supply of Tasmanian Public Hospital Admitted Patient and Emergency Department Presentations data; and the Registries of Births, Deaths and Marriages Tasmania, the Australian Coordinating Registry, the Coroners and the National Coronial Information System for Cause of Death Unit Record File data; the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) for provision of dialysis and transplant data - we are grateful to the Australian and New Zealand kidney units, patients and staff for their cooperation and contributions to ANZDATA; and the Tasmanian Data Linkage Unit for undertaking the linkage of these datasets. Some of the data reported here have been supplied by the Australia and New Zealand Dialysis and Transplant Registry. The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the Australia and New Zealand Dialysis and Transplant Registry. This study was made possible through funding from the Tasmanian Community Fund and the Royal Hobart Hospital Research Foundation. Dr. Clayton is supported by a Jacquot Research Establishment Award (Royal Australasian College of Physicians). Dr Irish is supported by a Postgraduate Research Scholarship (National Health and Medical Research Council, Australia). Open access publishing facilitated by University of Tasmania, as part of the Wiley - University of Tasmania agreement via the Council of Australian University Librarians. Funding Information: This study was made possible through funding from the Tasmanian Community Fund and the Royal Hobart Hospital Research Foundation. Dr. Clayton is supported by a Jacquot Research Establishment Award (Royal Australasian College of Physicians). Dr Irish is supported by a Postgraduate Research Scholarship (National Health and Medical Research Council, Australia). Open access publishing facilitated by University of Tasmania, as part of the Wiley ‐ University of Tasmania agreement via the Council of Australian University Librarians. Publisher Copyright: {\textcopyright} 2023 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.",
year = "2023",
month = jun,
doi = "10.1111/nep.14160",
language = "English",
volume = "28",
pages = "328--335",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "6",
}