Validation of the Klinrisk chronic kidney disease progression model in the FIDELITY population
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Validation of the Klinrisk chronic kidney disease progression model in the FIDELITY population. / Tangri, Navdeep; Ferguson, Thomas; Leon, Silvia J.; Anker, Stefan D.; Filippatos, Gerasimos; Pitt, Bertram; Rossing, Peter; Ruilope, Luis M.; Farjat, Alfredo E.; Farag, Youssef M. K.; Schloemer, Patrick; Lawatscheck, Robert; Rohwedder, Katja; Bakris, George L.
In: Clinical Kidney Journal, Vol. 17, No. 4, sfae052, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Validation of the Klinrisk chronic kidney disease progression model in the FIDELITY population
AU - Tangri, Navdeep
AU - Ferguson, Thomas
AU - Leon, Silvia J.
AU - Anker, Stefan D.
AU - Filippatos, Gerasimos
AU - Pitt, Bertram
AU - Rossing, Peter
AU - Ruilope, Luis M.
AU - Farjat, Alfredo E.
AU - Farag, Youssef M. K.
AU - Schloemer, Patrick
AU - Lawatscheck, Robert
AU - Rohwedder, Katja
AU - Bakris, George L.
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Chronic kidney disease (CKD) affects >800 million individuals worldwide and is often underrecognized. Early detection, identification and treatment can delay disease progression. Klinrisk is a proprietary CKD progression risk prediction model based on common laboratory data to predict CKD progression. We aimed to externally validate the Klinrisk model for prediction of CKD progression in FIDELITY (a prespecified pooled analysis of two finerenone phase III trials in patients with CKD and type 2 diabetes). In addition, we sought to identify evidence of an interaction between treatment and risk.METHODS: The validation cohort included all participants in FIDELITY up to 4 years. The primary and secondary composite outcomes included a ≥40% decrease in estimated glomerular filtration rate (eGFR) or kidney failure, and a ≥57% decrease in eGFR or kidney failure. Prediction discrimination was calculated using area under the receiver operating characteristic curve (AUC). Calibration plots were calculated by decile comparing observed with predicted risk.RESULTS: At time horizons of 2 and 4 years, 993 and 1795 patients experienced a primary outcome event, respectively. The model predicted the primary outcome accurately with an AUC of 0.81 for 2 years and 0.86 for 4 years. Calibration was appropriate at both 2 and 4 years, with Brier scores of 0.067 and 0.115, respectively. No evidence of interaction between treatment and risk was identified for the primary composite outcome (P = .31).CONCLUSIONS: Our findings demonstrate the accuracy and utility of a laboratory-based prediction model for early identification of patients at the highest risk of CKD progression.
AB - BACKGROUND: Chronic kidney disease (CKD) affects >800 million individuals worldwide and is often underrecognized. Early detection, identification and treatment can delay disease progression. Klinrisk is a proprietary CKD progression risk prediction model based on common laboratory data to predict CKD progression. We aimed to externally validate the Klinrisk model for prediction of CKD progression in FIDELITY (a prespecified pooled analysis of two finerenone phase III trials in patients with CKD and type 2 diabetes). In addition, we sought to identify evidence of an interaction between treatment and risk.METHODS: The validation cohort included all participants in FIDELITY up to 4 years. The primary and secondary composite outcomes included a ≥40% decrease in estimated glomerular filtration rate (eGFR) or kidney failure, and a ≥57% decrease in eGFR or kidney failure. Prediction discrimination was calculated using area under the receiver operating characteristic curve (AUC). Calibration plots were calculated by decile comparing observed with predicted risk.RESULTS: At time horizons of 2 and 4 years, 993 and 1795 patients experienced a primary outcome event, respectively. The model predicted the primary outcome accurately with an AUC of 0.81 for 2 years and 0.86 for 4 years. Calibration was appropriate at both 2 and 4 years, with Brier scores of 0.067 and 0.115, respectively. No evidence of interaction between treatment and risk was identified for the primary composite outcome (P = .31).CONCLUSIONS: Our findings demonstrate the accuracy and utility of a laboratory-based prediction model for early identification of patients at the highest risk of CKD progression.
U2 - 10.1093/ckj/sfae052
DO - 10.1093/ckj/sfae052
M3 - Journal article
C2 - 38650758
VL - 17
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
SN - 2048-8505
IS - 4
M1 - sfae052
ER -
ID: 390179054