Nash et al reported a model for predicting acute kidney injury and hyperkalemia in an older adult taking nonsteroidal anti-inflammatory drugs (NSAIDS). This can help to identify a patient who may require more aggressive management. The authors are from McMaster University, Ontario Renal Network, University of Maryland and Western University.
Patient selection: age >= 66 years with exposure to NSAIDs in the past 30 days
Outcome: acute kidney injury or hyperkalemia (>= 5.5 mmol/L)
Parameters:
(1) age in years
(2) sex
(3) baseline eGFR
(4) baseline serum potassium concentration in mmol/L
(5) therapy with ACEI or ARB
(6) therapy with a diuretic
Parameter
Finding
Beta Coefficient
age in years
0.013 * (years)
sex
female
0
male
0.36
baseline eGFR
-0.036 * (eGFR)
baseline serum potassium
0.58 * (potassium)
ACEI or ARB
no
0
yes
0.21
diuretic therapy
no
0
yes
0.57
X =
= SUM(beta-coefficients for all 6 parameters) - 6.02
probability of either acute kidney injury or hyperkalemia =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.72.
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