Derivation and Validation of Risk Scores to Predict Cerebrovascular Mortality Among Incident Peritoneal Dialysis...

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Epidemiology

Background:

• Cerebrovascular disease (CeVD) is a major cause of mortality in patients initiating peritoneal dialysis (PD).
• A validated risk score to predict CeVD risk upon PD initiation is currently lacking.
• This study addresses the need for a predictive tool for CeVD mortality in PD patients.

Purpose of the Study:

• To derive and validate a risk prediction model for cerebrovascular disease mortality within two years of initiating PD.
• To identify key clinical predictors for CeVD mortality in the PD population.

Main Methods:

• Utilized data from the Henan Peritoneal Dialysis Registry (HPDR) from 2007-2014.
• Applied multivariable logistic regression to develop the risk score, screening numerous clinical measurements.
• Performed internal validation using bootstrapping to assess model performance.

Main Results:

• The absolute risk of CeVD mortality was 2.9% in the study cohort.
• Key predictors identified for CeVD mortality include systolic and diastolic blood pressure, total cholesterol, phosphate, and sodium levels.
• The developed model demonstrated good discrimination (C-statistic > 0.70) and calibration.

Conclusions:

• A novel risk score, using readily available clinical data at PD initiation, can effectively predict CeVD mortality.
• This risk score can be clinically applied to screen PD patients at high risk for CeVD.
• Early identification may facilitate targeted therapies to reduce CeVD-related events in PD patients.