Doi et al developed a risk score for predicting 1-year mortality for a patient starting hemodialysis. The authors are from Hiroshima University, Niigata University, Anjo Kosei Hospital, Okayama University, Fukushima Medical University Hospital, Kyoto University and iHope International in Kyoto.
Patient selection: stage 5 chronic kidney disease starting hemodialysis, under predialysis nephrology care
Outcome: 1 year mortality
Parameters:
(1) eGFR in mL per min per 1.73 square meter
(2) serum albumin in g/dL
(3) serum calcium in mg/dL
(4) modified Charlson comorbidity index (CCI), by excluding diabetes and renal disease
(5) WHO performance status
(6) erythropoiesis stimulating agent (ESA)
|
Parameter |
Finding |
Points |
|
eGFR |
<= 7 mL/min per 1.73 sq m |
0 |
|
|
> 7 mL/min per 1.73 sq m |
1 |
|
serum albumin |
>= 3.5 g/dL |
0 |
|
|
< 3.5 g/dL |
1 |
|
serum calcium |
<=8.5 mg/dL |
0 |
|
|
> 8.5 mg/dL |
2 |
|
modified CCI |
0 |
0 |
|
|
1 or 2 |
2 |
|
|
>= 3 |
3 |
|
performance status |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
3 or 4 |
3 |
|
erythropoiesis stimulation |
no |
2 |
|
|
yes |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk for the patient.
|
Score |
1-Year Mortality |
|
0 to 4 |
2.5% |
|
5 or 6 |
5.5% |
|
7 or 8 |
15% |
|
9 to 12 |
29% |
Performance:
• The area under the ROC curve was 0.83.
Specialty: Nephrology, Clinical Laboratory
