Tangri et al reported a model for predicting if a patient with chronic kidney disease will progress to renal failure within 5 years. The authors are from Tufts Meical Center, University of British Columbia, and University of Toronto.
Patient selection: eGFR < 60 mL per min per 1.73 sq meters
Parameters:
(1) eGFR in mL per min per 1.73 sq meters
(2) sex
(3) urine albumin to creatinine ratio (ACR) in mg/g
(4) age in years
(5) serum albumin in g/dL
(6) serum phosphate in mg/dL
(7) serum bicarbonate in mmol/L
(8) serum calcium in mg/dL
|
Parameter |
Finding |
Points |
|
eGFR |
10-14 |
-35 |
|
|
15-19 |
-30 |
|
|
20-24 |
-25 |
|
|
25-29 |
-20 |
|
|
30-34 |
-15 |
|
|
35-39 |
-10 |
|
|
40-44 |
-5 |
|
|
45-49 |
0 |
|
|
50-54 |
5 |
|
|
55-59 |
10 |
|
sex |
female |
0 |
|
|
male |
-2 |
|
ACR |
< 30 |
0 |
|
|
30 to 300 |
-14 |
|
|
> 300 |
-22 |
|
age |
< 30 |
-4 |
|
|
30-39 |
-2 |
|
|
40-49 |
0 |
|
|
50-59 |
3 |
|
|
60-69 |
4 |
|
|
70-79 |
8 |
|
|
80-89 |
8 |
|
|
>= 90 |
10 |
|
serum albumin |
<= 2.5 |
-5 |
|
|
2.6-3.0 |
0 |
|
|
3.1-3.5 |
2 |
|
|
>=3.6 |
4 |
|
serum phosphorus |
< 3.5 |
3 |
|
|
3.5-4.5 |
0 |
|
|
4.6-5.5 |
-3 |
|
|
> 5.5 |
-5 |
|
serum bicarbonate |
< 18 |
-7 |
|
|
18-22 |
-4 |
|
|
23-25 |
-1 |
|
|
>25 |
0 |
|
serum calcium |
<= 8.5 |
-3 |
|
|
8.6-9.5 |
0 |
|
|
> 9.5 |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -83
• maximum score: 29
• The lower the score the greater the risk of renal failure within 5 years.
|
Total Score |
5-Year Risk Renal Failure |
|
< -41 |
> 90% |
|
-41 |
89% |
|
-40 |
86.9% |
|
-39 |
84.1% |
|
-38 |
81% |
|
-37 |
77.8% |
|
-36 |
74.4% |
|
-35 |
70.9% |
|
-34 |
67.3% |
|
-33 |
63.6% |
|
-32 |
59.9% |
|
-31 |
56.3% |
|
-30 |
52.8% |
|
-29 |
49.3% |
|
-28 |
45.9% |
|
-27 |
42.7% |
|
-26 |
39.6% |
|
-25 |
36.6% |
|
-24 |
33.8% |
|
-23 |
31.2% |
|
-22 |
28.7% |
|
-21 |
26.4% |
|
-20 |
24.2% |
|
-19 |
22.2% |
|
-18 |
20.3% |
|
-17 |
18.6% |
|
-16 |
17% |
|
-15 |
15.5% |
|
-14 |
14.1% |
|
-13 |
12.9% |
|
-12 |
11.7% |
|
-11 |
10.7% |
|
-10 |
9.7% |
|
-9 |
8.8% |
|
-8 |
8% |
|
-7 |
7.3% |
|
-6 |
6.6% |
|
-5 |
6% |
|
-4 |
5.5% |
|
>= -3 |
< 5% |
value of X =
= (0.001357 * ((score)^2)) - (0.6678 * (score)) - 3.055
probability of renal failure =
= 1 / (1 + EXP((-10 * X))
Specialty: Nephrology
