Materiały źródłowe

• #1 End-Stage Renal Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499861/

  End-stage renal disease is a progressive disorder, and timely renal replacement therapy is necessary to prevent death. The disorder is associated with numerous hospitalizations, increased healthcare costs, and metabolic changes. The mortality rates for patients with end-stage renal disease are significantly higher than those without the disease. Even with timely dialysis, the death rates vary from 20% to 50% over 24 months. The most common cause of death is hyperkalemia, followed by adverse cardiac events. Mortality rates are higher for men than women; similarly, Blacks are more prone to death due to ESRD than Whites. The highest mortality rate is within the first six months of starting dialysis. The 5-year survival rate for a patient undergoing long-term dialysis in the United States is approximately 35% and about 25% in patients with diabetes. […] In children, puberty is delayed in both genders, and low vitamin D levels are common, an independent risk factor for death.

• #2 Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/238798-overview

  The mortality rates associated with CKD are striking. After adjustment for demographics and comorbidities, deaths in 2019 in patients with and without CKD were 94.5 versus 41.5 per 1000 person-years, respectively. For patients with ESKD, the adjusted mortality rate in 2019 was 128.5 per 1000 person-years. Mortality rates rose sharply with the COVID-19 pandemic; in kidney transplant recipients, for example, mortality rates (which had decreased by nearly 5% from 2011 to 2019) increased by 34.0% in 2020 and by a further 16.3% in 2021. In the overall CKD population, however, mortality rates decreased by about 2% from 2020 to 2021. […] The highest mortality rate is within the first 6 months of initiating dialysis. Mortality then tends to improve over the next 6 months, before increasing gradually over the next 4 years. The 5-year survival rate for a patient undergoing long-term dialysis in the United States is approximately 35%, and approximately 25% in patients with diabetes.

• #3 Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/238798-overview

  At every age, patients with ESKD on dialysis have significantly higher mortality than nondialysis patients and individuals without kidney disease. At age 60 years, a healthy person can expect to live for more than 20 years, whereas the life expectancy of a patient aged 60 years who is starting hemodialysis is closer to 4 years. Among patients aged 65 years or older who have ESKD, mortality rates are 6 times higher than in the general population.

• #4 End Stage Renal Disease (ESRD): Symptoms and More

  https://www.healthline.com/health/end-stage-kidney-disease

  End-stage kidney disease is also called end-stage renal disease (ESRD). The kidneys of people with ESRD function below 15% of their normal ability, which may mean theyre barely functioning or not functioning at all. […] Even with dialysis, the rate of death from ESRD ranges between 20-50% in two years, and this rate is higher for Black people than those who are white. The 5-year survival rate if youre undergoing dialysis in the U.S. is about 35%. Its 25% if youre also living with diabetes. […] A transplant allows you to resume healthy kidney function. If you follow your doctors recommendations for diet and lifestyle changes, a kidney transplant can help you live free from ESRD for many years. […] While ESRD can be life threatening, these treatments can help significantly prolong your life.

• #5 Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03503-3

  Findings from this study will provide important information to build prognostic tools to support early identification of patients with ESRD who would benefit from integrated renal supportive care interventions. […] This present review examined the risk factors that predicted short-term all-cause mortality for patients with ESRD. Measures of poor health, access to health information and intradialytic blood pressure had the highest percentage of papers reporting a significant association with short-term all-cause mortality risk. Among the risk factors frequently examined, CRP, age, and functional status were observed to be included in a high percentage of models that were significantly associated with short-term all-cause mortality. […] In conclusion, this study has found multiple factors which influence short-term all-cause mortality in patients with ESRD. While there are consistent findings for CRP and functional status, evidence for type of vascular access is insufficient. Commonly examined risk factors observed from this review may be used to build a general prognostic model for patients with ESRD, with the addition of treatment-specific risk factors to enhance accuracy.

• #6 Chronic Kidney Disease (CKD): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/238798-overview

  Patients with chronic kidney disease (CKD) generally experience progressive loss of kidney function and are at risk for end-stage kidney disease (ESKD). The rate of progression depends on age, the underlying diagnosis, the implementation and success of secondary preventive measures, and the individual patient. Timely initiation of long-term renal replacement therapy is imperative to prevent the uremic complications of CKD that can lead to significant morbidity and death. […] Tangri et al developed and validated a model in adult patients that uses routine laboratory results to predict progression from CKD (stages 3-5) to kidney failure. They reported that lower estimated glomerular filtration rate (GFR), higher albuminuria, younger age, and male sex pointed to a faster progression of kidney failure. Also, a lower serum albumin, calcium, and bicarbonate level and a higher serum phosphate level predicted an elevated risk of kidney failure.

• #7 The Kidney Failure Risk Equation for prediction of end stage renal disease in UK primary care: An external validation and clinical impact projection cohort study | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002955

  The Kidney Failure Risk Equation (KFRE) uses the 4 variables of age, sex, urine albumin-to-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR) in individuals with chronic kidney disease (CKD) to predict the risk of end stage renal disease (ESRD), i.e., the need for dialysis or a kidney transplant, within 2 and 5 years. […] The study’s objectives were therefore to externally validate the KFRE’s prediction of ESRD events in primary care, perform model recalibration if necessary, and assess its projected impact on referral rates to secondary care renal services. […] In this cohort, the recalibrated KFRE accurately predicted the risk of ESRD at 2 and 5 years in primary care. Its introduction into primary care for referrals to secondary care renal services may lead to a reduction in unnecessary referrals, and earlier referrals in those who go on to develop ESRD.

• #8 The Kidney Failure Risk Equation for prediction of end stage renal disease in UK primary care: An external validation and clinical impact projection cohort study | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002955

  The KFRE has been suggested as a triage tool for CKD referrals from primary to secondary care, with a 5-year risk of ESRD of 3% or 5% suggested as a referral criterion. […] The current independent external validation and clinical impact projection study of the KFRE confirms the findings from the development cohort in relation to discrimination and calibration. […] Discrimination was again found to be excellent for prediction of ESRD within both 2 and 5 years. […] The necessity for KFRE recalibration is explained by several factors. […] The clinical impact projection element of the study focused on different recommendations for the KFRE calculated risk level, compared to current NICE guidelines for secondary care CKD referral. […] Using the recalibrated KFRE alone led to either additional eventual ESRD cases not being eligible for referral at the study’s baseline or large increases in the proportion of the CKD population referred, thus representing no improvement from the current NICE recommendations. […] Overall, a recalibrated-KFRE-driven risk-based approach with the addition of the ACR-based criterion for referral may lead to more appropriate referrals to secondary care, conserving resources and reducing for patients the associated psychological stress of referral.

• #9 Development and validation of a risk prediction model for end-stage renal disease in patients with type 2 diabetes | Scientific Reports

  https://www.nature.com/articles/s41598-017-09243-9

  The aim of this study is to develop a prediction model for ESRD in patients with type 2 diabetes. […] The risk prediction for 3-year, 5-year, and 8-year period demonstrated good predictive accuracy and discriminatory ability. […] Predicting ESRD risks in patients with type 2 diabetes can help guide individualized interventions for secondary prevention and future health care needs. […] Our study established an ESRD risk prediction model in a nationwide cohort of patients with type 2 diabetes. […] The present study showed excellent discrimination ability (AUCs of 0.90) for ESRD risk score in Chinese patients with type 2 diabetes. […] Our study developed 3-, 5-, and 8-year ESRD risk scores with good prediction accuracy and discriminatory ability.

• #10 Investigation of end-stage kidney disease risk prediction in an ethnically diverse cohort of people with type 2 diabetes: use of kidney failure risk equation | BMJ Open Diabetes Research & Care

  https://drc.bmj.com/content/12/4/e004282

  Although derived for predicting KF, KFRE also demonstrated good discrimination for ESKD outcome. […] Further studies are needed to identify variables/biomarkers that may improve KFREs performance/calibration and to aid the development of other predictive models to enable early identification of people at risk of advanced stages of CKD prior to onset of KF. […] We demonstrated that KFRE remains a useful tool to use for predicting progression to end-stage kidney disease defined by either estimated glomerular filtration rate 10 or 15 mL/min/1.73 m2 in people with type 2 diabetes. […] Our primary aim is to evaluate whether we can prove the concept of evaluating the performance of KFRE in predicting the risk of ESKD considered as the endpoint defined primarily by eGFR 10 mL/min/1.73 m2. […] Our observations suggest that although an adequate KFRE discrimination was obtained, greater calibration would be required for its application to predict ESKD whether defined as a sustained eGFR 10 or as a sustained eGFR 15 mL/min/1.73 m2.

• #11 Investigation of end-stage kidney disease risk prediction in an ethnically diverse cohort of people with type 2 diabetes: use of kidney failure risk equation | BMJ Open Diabetes Research & Care

  https://drc.bmj.com/content/12/4/e004282

  Our findings also suggest that recalibration using our cohort data improved the calibration performance of the original KFRE. […] In conclusion, in this study, with large ethnically diverse cohort of people with T2DM and CKD with eGFR 60 mL/min/1.73 m2, our investigation showed that the discrimination of KFRE between people experiencing ESKD from those who did not was good at 2 and 5 years, respectively.

• #12 Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach – ADS

  https://ui.adsabs.harvard.edu/abs/2024arXiv241001859L/abstract

  Objective: To improve prediction of Chronic Kidney Disease (CKD) progression to End Stage Renal Disease (ESRD) using machine learning (ML) and deep learning (DL) models applied to an integrated clinical and claims dataset of varying observation windows, supported by explainable AI (XAI) to enhance interpretability and reduce bias. […] Results: Integrated data models outperformed those using single data sources, with the Long Short-Term Memory (LSTM) model achieving the highest AUC (0.93) and F1 score (0.65). […] Improved ESRD prediction accuracy, results interpretability and bias mitigation strategies presented in this study have the potential to significantly enhance CKD and ESRD management, support targeted early interventions and reduce healthcare disparities. […] Conclusion: This study presents a robust framework for predicting ESRD outcomes in CKD patients, improving clinical decision-making and patient care through multi-sourced, integrated data and AI/ML methods.

• #13 Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach

  https://arxiv.org/html/2410.01859v2

  Objective: To improve prediction of Chronic Kidney Disease (CKD) progression to End Stage Renal Disease (ESRD) using machine learning (ML) and deep learning (DL) models applied to an integrated clinical and claims dataset of varying observation windows, supported by explainable AI (XAI) to enhance interpretability and reduce bias. […] Improved ESRD prediction accuracy, results interpretability and bias mitigation strategies presented in this study have the potential to significantly enhance CKD and ESRD management, support targeted early interventions and reduce healthcare disparities. […] This study presents a robust framework for predicting ESRD outcomes in CKD patients, improving clinical decision-making and patient care through multi-sourced, integrated data and AI/ML methods. […] We identified a 24-month observation window as optimal for balancing early detection and prediction accuracy, with LSTM proving most effective among deep learning models and XGBoost leading in machine learning.

• #14 Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach

  https://arxiv.org/html/2410.01859v2

  The use of a 24-month observation window, identified as the optimal period for accurate predictions, allows for timely and reliable risk assessment, providing a critical balance between early detection and maintaining a manageable error rate. […] These findings highlight the importance of a multi-faceted approach to data integration, which can lead to more inclusive and accurate models for managing chronic diseases such as CKD. […] This focus on observation period optimization is crucial for balancing the need for timely interventions with the risks of premature or inaccurate predictions. […] By rigorously evaluating different observation window lengths, we were able to identify a 24-month period as optimal, providing a critical framework for clinicians to monitor and manage CKD progression effectively.

• #15 Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/20037172/

  Quality of life (QOL) may be associated with morbidity and survival in end-stage renal disease (ESRD), and is considered to be an important outcome measure for patients with chronic kidney disease (CKD). […] The total scores and scores of both physical and psychological domains predicted dialysis and mortality (every 1-point decrease hazard ratio (HR): 1.050, 95% CI: 1.008-1.095, P = 0.020; HR: 1.179, CI: 1.033-1.346, P = 0.014; HR: 1.167, CI: 1.016-1.339, P = 0.028, respectively). […] Physical, psychological and total scores of QOL are significantly correlated with increased risks of ESRD and death in CKD patients. QOL should be considered as an independent predictor of risks of ESRD and mortality.

• #16 Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: a cross-sectional study | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-021-02494-9

  End-Stage Kidney Disease, the most severe form of chronic kidney disease, is fatal if not treated by renal replacement therapy. Thus, patients with End-Stage Kidney Disease depend on hemodialysis as a lifesaving treatment for the remainder of their lives. […] Nearly half of the patients with ESKD on hemodialysis had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Elderly patients had lower mean score of burden of kidney disease. […] The lower HRQoL score among the patients has several clinical implications. As HRQoL is one of the indicators of clinical outcome of the patients, the lower scores may indicate poor prognosis of the patients and compromised quality of clinical care. […] HRQOL was found to be associated with unemployment status of the patients and frequency of the hemodialysis.

• #17 Renal response status to predict long-term renal survival in patients with lupus nephritis: results from the Toronto Lupus Cohort | Lupus Science & Medicine

  https://lupus.bmj.com/content/11/2/e001264

  Achieving mPERR or mCRR was associated with improved long-term renal survival, highlighting that these statuses are suitable predictors of long-term renal outcomes in patients with LN. […] Lupus nephritis (LN), a severe manifestation of systemic lupus erythematosus, may lead to permanent, irreversible chronic kidney disease and, if not managed, to end-stage kidney disease (ESKD), a condition that is associated with poor disease prognosis. […] The results of this study demonstrate that achieving mPERR or mCRR at 2 years following biopsy-proven LN diagnosis is associated with favourable long-term (up to 25 years) renal survival. […] Data from this study confirm the use of mPERR or mCRR as prognostic measures for long-term renal outcomes in patients with LN. […] Achieving mPERR at index was associated with an increased likelihood of long-term renal survival versus not achieving mPERR (log-rank p=0.0119).

• #18 Renal response status to predict long-term renal survival in patients with lupus nephritis: results from the Toronto Lupus Cohort | Lupus Science & Medicine

  https://lupus.bmj.com/content/11/2/e001264

  Achieving mCRR at index was associated with an increased likelihood of long-term renal survival versus not achieving mCRR (log-rank p=0.0259). […] The findings of this study emphasise the potential generalisability of mPERR status as a predictor of long-term renal survival in patients with LN, with and without mild CKD progression. […] Our data also support mCRR as a measure for predicting long-term renal survival, despite being a more stringent set of criteria than the mPERR.

• #19 Risk Score to Predict 1-Year Mortality after Haemodialysis Initiation in Patients with Stage 5 Chronic Kidney Disease under Predialysis Nephrology Care | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129180

  Few risk scores are available for predicting mortality in chronic kidney disease (CKD) patients undergoing predialysis nephrology care. Here, we developed a risk score using predialysis nephrology practice data to predict 1-year mortality following the initiation of haemodialysis (HD) for CKD patients. […] We developed a simple 6-item risk score predicting 1-year mortality after the initiation of HD that might help nephrologists make a shared decision with patients and families regarding the initiation of HD. […] Our risk score to predict 1-year mortality is composed of the following six items available at initiation of HD: high eGFR level (7 mL/min per 1.73 m2), low serum albumin levels, high calcium levels, high modified CCI, low performance status, and no use of ESA. […] The strength of this study is that the 6-item risk score for predicting 1-year mortality was developed using clinical data available immediately before the initiation of HD from multicenter nephrology institutions.

• #20 Risk Score to Predict 1-Year Mortality after Haemodialysis Initiation in Patients with Stage 5 Chronic Kidney Disease under Predialysis Nephrology Care | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129180

  In conclusion, we developed and validated a simple risk score in CKD patients receiving predialysis nephrology care to predict 1-year mortality after the initiation of HD. This score might help nephrologists make personalized assessments for risk of mortality and facilitate making a shared decision with patients and families regarding the initiation of HD.

• #21 The Kidney Failure Risk Equation

  https://kidneyfailurerisk.com/

  Using the patient’s Urine, Sex, Age and GFR, the kidney failure risk equation provides the 2 and 5 year probability of treated kidney failure for a potential patient with CKD stage 3 to 5. […] The four and eight variable equations accurately predict the 2 and 5 year probability of treated kidney failure (dialysis or transplantation) for a potential patient with CKD Stage 3 to 5. […] Determining the probability of kidney failure may be useful for patient and provider communication, triage and management of nephrology referrals and timing of dialysis access placement and living related kidney transplant. […] For patients with localized kidney cancer facing either a partial or radical nephrectomy, the Kidney Cancer Risk Equation (KCRE) can be used to predict the risk of kidney failure 5-years after kidney cancer surgery. Knowing your risk can help inform treatment decisions, such as surgery (partial versus radical nephrectomy), or watchful waiting. […] Patient risk of progression to kidney failure requiring dialysis or transplant after kidney cancer surgery:

• #22 [2410.01859] Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach

  https://arxiv.org/abs/2410.01859

  Objective: To improve prediction of Chronic Kidney Disease (CKD) progression to End Stage Renal Disease (ESRD) using machine learning (ML) and deep learning (DL) models applied to an integrated clinical and claims dataset of varying observation windows, supported by explainable AI (XAI) to enhance interpretability and reduce bias. […] Improved ESRD prediction accuracy, results interpretability and bias mitigation strategies presented in this study have the potential to significantly enhance CKD and ESRD management, support targeted early interventions and reduce healthcare disparities. […] This study presents a robust framework for predicting ESRD outcomes in CKD patients, improving clinical decision-making and patient care through multi-sourced, integrated data and AI/ML methods.

• #23 Enhancing End Stage Renal Disease Outcome Prediction: A Multi-Sourced Data-Driven Approach

  https://arxiv.org/html/2410.01859v2

  The insights derived from our research have significant practical implications for early intervention strategies in CKD management. […] This approach aligns with the goals of personalized medicine, where treatment plans are tailored to the specific needs and risk profiles of individual patients. […] Overall, this study advances chronic disease management by utilizing integrated data and innovative AI techniques, paving the way for more accurate, personalized, and equitable care in CKD management.

• #24 Prevalence Prognosis of the End Stage Renal Disease Patients in Greece | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-642-03904-1_66

  Greece owns a place among the ten first countries internationally with the highest prevalent number of end stage renal disease (ESRD) patients, and among the first five with the highest incidence. […] Predicting the future number of ESRD patients can be utilized in healthcare decision making in order to achieve a more effective resource management. […] This study concludes that there will be a 12.6% and 7.1% increase in ESRD prevalence and incidence respectively, for the period 2006-2012.

• #25 Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review | BMC Nephrology | Full Text

  https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03503-3

  There is a lack of prognostic information to guide the prediction of short-term all-cause mortality in patients with end-stage renal disease (ESRD). The aim was to review the risk factors that influenced the risk of short-term all-cause mortality in patients with ESRD. […] Commonly examined risk factors observed from this review may be used to build a general prognostic model for patients with ESRD, with specific treatment related risk factors added on to enhance the accuracy of the models. […] The average life expectancy of ESRD patients on renal replacement therapy or conservative treatment is 210 years. Therefore, an individualised prognostic framework based on 3-year mortality will support decision making for patients and families by providing valuable information on treatment options and likely outcomes.

• #26 Prediction of Postoperative Complications for Patients of End Stage Renal Disease

  https://www.mdpi.com/1424-8220/21/2/544

  End stage renal disease (ESRD) is the last stage of chronic kidney disease that requires dialysis or a kidney transplant to survive. Many studies reported a higher risk of mortality in ESRD patients compared with patients without ESRD. […] Indeed, the literature consistently demonstrated a higher risk of mortality in ESRD patients compared with patients without ESRD, both in the cardiac and noncardiac perioperative periods. Across various types of noncardiac surgery, patients with chronic kidney disease had two- to tenfold higher risks of postoperative death and cardiovascular events than those with normal kidney function. […] Therefore, predicting the risk is important in reducing these complications. The purpose of this study is to make a proper models for predicting postoperative major cardiac event (MACE) in ESRD patients undergoing general anesthesia.

• #27 Prediction of Postoperative Complications for Patients of End Stage Renal Disease

  https://www.mdpi.com/1424-8220/21/2/544

  Our contributions can be summarized as follows. First, as far as we know, this is the first study to predict post-operative MACE in patients with ESRD using various machine learning models. […] We believe that our work will be helpful for physicians to make better medical decisions based on the information provided by our model.

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