title: A simple tool to predict end-stage renal disease within 1 year in elderly adults with advanced chronic kidney disease.
abstract: OBJECTIVE
  To develop and validate a model to predict 1-year risk of end-stage renal disease (ESRD) in elderly subjects with advanced chronic kidney disease (CKD).
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Veterans Affairs Medical Center.
  
  
  METHODS
  Individuals aged 65 and older with CKD with an estimated glomerular filtration rate (eGFR) less than 30 mL/min per 1.73 m(2) .
  
  
  METHODS
  The outcome was ESRD within 1 year of the index eGFR. Cox regression was used to develop a predictive model (Veterans Affairs (VA) risk score) that was validated in a separate cohort.
  
  
  RESULTS
  Of the 1,866 participants in the developmental cohort, 77 developed ESRD. Risk factors for ESRD in the final model were age, congestive heart failure, systolic blood pressure, eGFR, potassium, and albumin. In the validation cohort, the C index for the VA risk score was 0.823. The risk for developing ESRD at 1 year from lowest to highest tertile was 0.08%, 2.7%, and 11.3% (P < .001). The C-index for the recently published Tangri model in the validation cohort was 0.780.
  
  
  CONCLUSIONS
  A new model using commonly available clinical measures shows excellent ability to predict the onset of ESRD within the next year in elderly adults. The Tangri model also had good predictive ability. Individuals and physicians can use these risk models to inform decisions regarding preparation for renal replacement therapy in individuals with advanced CKD.
authors.affiliation: Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, Minnesota 55414, USA. draw0003@umn.edu
authors.forename: Paul E
authors.initials: PE
authors.lastname: Drawz
authors.forename: Puja
authors.initials: P
authors.lastname: Goswami
authors.forename: Reem
authors.initials: R
authors.lastname: Azem
authors.forename: Denise C
authors.initials: DC
authors.lastname: Babineau
authors.forename: Mahboob
authors.initials: M
authors.lastname: Rahman
mesh_terms: D000367:Age Factors; D000368:Aged; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009820:Ohio / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D014728:Veterans