Beatriz Escamilla-Cabrera , Marco Montomoli , Maria Kislikova , Verónica de la Espada , Alazne Olarte-García , Ana María García-Prieto , Sara Piqueras-Sánchez , Álvaro Álvarez López , Lucía Rodríguez-Gayo , Javier Centellas-Pérez , Hilda Villafuerte , Pedro Barrera Baena
{"title":"Multicenter validation of the Kidney Failure Risk Equation (KFRE) formula in Spanish patients with advanced chronic kidney disease","authors":"Beatriz Escamilla-Cabrera , Marco Montomoli , Maria Kislikova , Verónica de la Espada , Alazne Olarte-García , Ana María García-Prieto , Sara Piqueras-Sánchez , Álvaro Álvarez López , Lucía Rodríguez-Gayo , Javier Centellas-Pérez , Hilda Villafuerte , Pedro Barrera Baena","doi":"10.1016/j.nefroe.2025.05.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is a prevalent condition that requires reliable tools to predict its progression to end-stage renal disease (ESRD). The KFRE equation, internationally validated, allows for estimating the risk of progression at 2 and 5 years. However, it has not been validated in the Spanish population. This study aims to evaluate the predictive capacity of the KFRE in a cohort of Spanish patients.</div></div><div><h3>Methods</h3><div>This is a multicenter, observational, and retrospective study conducted in patients with an estimated glomerular filtration rate (eGFR)<!--> <!--><<!--> <!-->30<!--> <!-->ml/min who were followed in nephrology clinics between January 2016 and 2021. A total of 602 patients with clinical and demographic data were included. The predictive capacity of the KFRE, in its 4-variable and 8-variable versions, was evaluated using Cox regression analysis and ROC curves.</div></div><div><h3>Results</h3><div>Of the 602 patients included, 60% were male. Diabetes was the main etiology. Among the patients who started renal replacement therapy (RRT), 37% did so within two years, and 70% began with hemodialysis. Patients who initiated RRT (50.6%) were younger, had a lower eGFR, and exhibited higher baseline albuminuria. The 4-variable KFRE equation showed an AUC of 0.7639 (95% CI: 0.71−0.81) and demonstrated superior accuracy compared to the 8-variable model.</div></div><div><h3>Conclusions</h3><div>The KFRE equation, particularly in its 4-variable version, proves to be useful in predicting the progression to ESRD in the Spanish population. However, recalibration is necessary to improve its accuracy in this context.</div></div>","PeriodicalId":31770,"journal":{"name":"Nefrologia English Edition","volume":"45 5","pages":"Pages 388-396"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nefrologia English Edition","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2013251425000768","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Chronic kidney disease (CKD) is a prevalent condition that requires reliable tools to predict its progression to end-stage renal disease (ESRD). The KFRE equation, internationally validated, allows for estimating the risk of progression at 2 and 5 years. However, it has not been validated in the Spanish population. This study aims to evaluate the predictive capacity of the KFRE in a cohort of Spanish patients.
Methods
This is a multicenter, observational, and retrospective study conducted in patients with an estimated glomerular filtration rate (eGFR) < 30 ml/min who were followed in nephrology clinics between January 2016 and 2021. A total of 602 patients with clinical and demographic data were included. The predictive capacity of the KFRE, in its 4-variable and 8-variable versions, was evaluated using Cox regression analysis and ROC curves.
Results
Of the 602 patients included, 60% were male. Diabetes was the main etiology. Among the patients who started renal replacement therapy (RRT), 37% did so within two years, and 70% began with hemodialysis. Patients who initiated RRT (50.6%) were younger, had a lower eGFR, and exhibited higher baseline albuminuria. The 4-variable KFRE equation showed an AUC of 0.7639 (95% CI: 0.71−0.81) and demonstrated superior accuracy compared to the 8-variable model.
Conclusions
The KFRE equation, particularly in its 4-variable version, proves to be useful in predicting the progression to ESRD in the Spanish population. However, recalibration is necessary to improve its accuracy in this context.