title: Development and Validation of a Risk Score for Prediction of Acute Kidney Injury in Patients With Acute Decompensated Heart Failure: A Prospective Cohort Study in China.
abstract: Although several risk factors for acute kidney injury (AKI) have been identified, early detection of AKI in acute decompensated heart failure patients remains a challenge. The aim of this study was to develop and validate a risk score for early prediction of AKI in acute decompensated heart failure patients.
  
  
  
  A total of 676 consecutive acute decompensated heart failure participants were prospectively enrolled from 6 regional central hospitals. Data from 507 participants were analyzed. Participants from 4 of the 6 hospitals (n=321) were used to develop a risk score and conduct internal validation. External validation of the developed risk score was conducted in participants from the other 2 hospitals (n=186). Sequential logistic regression was used to develop and validate the risk score. The c statistic and calibration plot were used to assess the discrimination and calibration of the proposed risk score. The overall occurrence of AKI was 33.1% (168/507). The risk score, ranging from 0 to 55, demonstrated good discriminative power with an optimism-corrected c statistic of 0.859. Similar results were obtained from external validation with c statistic of 0.847 (95% CI 0.819-0.927). The risk score had good calibration with no apparent over- or under-prediction observed from calibration plots.
  
  
  
  The novel risk score is a simple and accurate tool that can help clinicians assess the risk of AKI in acute decompensated heart failure patients, which in turn helps them plan and initiate the most appropriate disease management for patients in time.
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China.|Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Li Zhi
authors.initials: LZ
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China.|Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xiao Bing
authors.initials: XB
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China.|Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Guan
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China.|Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Biostatistics, Bioinformatics & Biomathematics, Georgetown University, Washington, DC.
authors.forename: Ming T
authors.initials: MT
authors.lastname: Tan
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China chenpy99@126.com ffhouguangzhou@163.com.|Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Fan Fan
authors.initials: FF
authors.lastname: Hou
authors.affiliation: State Key Laboratory of Organ Failure Research, National Clinical Research Center for Kidney Disease, Guangzhou, China chenpy99@126.com ffhouguangzhou@163.com.|Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
authors.forename: Ping Yan
authors.initials: PY
authors.lastname: Chen
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000453:epidemiology*; D000368:Aged; D000369:Aged, 80 and over; D000808:Angiotensinogen / Q000652:urine; D059347:Cardio-Renal Syndrome / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D000071068:Lipocalin-2 / Q000652:urine; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: C489506:LCN2 protein, human; D000071068:Lipocalin-2; D000808:Angiotensinogen
keywords: acute decompensated heart failure; acute kidney injury; risk prediction; risk stratification