title: Risk prediction models for patients with chronic kidney disease: a systematic review.
abstract: BACKGROUND
  Patients with chronic kidney disease (CKD) are at increased risk for kidney failure, cardiovascular events, and all-cause mortality. Accurate models are needed to predict the individual risk for these outcomes.
  
  
  OBJECTIVE
  To systematically review risk prediction models for kidney failure, cardiovascular events, and death in patients with CKD.
  
  
  METHODS
  MEDLINE search of English-language articles published from 1966 to November 2012.
  
  
  METHODS
  Cohort studies that examined adults with any stage of CKD who were not receiving dialysis and had not had a transplant; had at least 1 year of follow-up; and reported on a model that predicted the risk for kidney failure, cardiovascular events, or all-cause mortality.
  
  
  METHODS
  Reviewers extracted data on study design, population characteristics, modeling methods, metrics of model performance, risk of bias, and clinical usefulness.
  
  
  RESULTS
  Thirteen studies describing 23 models were found. Eight studies (11 models) involved kidney failure, 5 studies (6 models) involved all-cause mortality, and 3 studies (6 models) involved cardiovascular events. Measures of estimated glomerular filtration rate or serum creatinine level were included in 10 studies (17 models), and measures of proteinuria were included in 9 studies (15 models). Only 2 studies (4 models) met the criteria for clinical usefulness, of which 1 study (3 models) presented reclassification indices with clinically useful risk categories.
  
  
  CONCLUSIONS
  A validated risk-of-bias tool and comparisons of the performance of different models in the same validation population were lacking.
  
  
  CONCLUSIONS
  Accurate, externally validated models for predicting risk for kidney failure in patients with CKD are available and ready for clinical testing. Further development of models for cardiovascular events and all-cause mortality is needed.
  
  
  BACKGROUND
  None.
authors.affiliation: Seven Oaks General Hospital, 2PD-13, 2300 McPhillips Street, Winnipeg, Manitoba R2V 3M3, Canada. ntangri@sogh.mb.ca
authors.forename: Navdeep
authors.initials: N
authors.lastname: Tangri
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kitsios
authors.forename: Lesley Ann
authors.initials: LA
authors.lastname: Inker
authors.forename: John
authors.initials: J
authors.lastname: Griffith
authors.forename: David M
authors.initials: DM
authors.lastname: Naimark
authors.forename: Simon
authors.initials: S
authors.lastname: Walker
authors.forename: Claudio
authors.initials: C
authors.lastname: Rigatto
authors.forename: Katrin
authors.initials: K
authors.lastname: Uhlig
authors.forename: David M
authors.initials: DM
authors.lastname: Kent
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Levey
mesh_terms: D015982:Bias; D002318:Cardiovascular Diseases / Q000209:etiology*; D002423:Cause of Death; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D015233:Models, Statistical; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality*; D018570:Risk Assessment; D012307:Risk Factors