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The Senior Hospitalized Adults' Risk Prediction Score for Acute Kidney Injury: Derivation and External Validation
Youlu Zhao1,2,3,4,5,6, Jinwei Wang1,2,3,4,5,6, Damin Xu1,2,3,4,5,6
1Renal Division, Peking University First Hospital, Beijing, China.
Nephrology (Carlton, Vic.)
|April 9, 2026
Summary
A new Senior Hospitalized Adults' AKI Risk Prediction (SHARP) score identifies older patients at risk for acute kidney injury (AKI). This practical tool aids early intervention by stratifying risk effectively.
Area of Science:
- Geriatric Medicine
- Nephrology
- Clinical Prediction Modeling
Background:
- Acute kidney injury (AKI) is a significant complication in elderly hospitalized patients.
- Early identification of high-risk individuals is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To develop and validate a practical prediction model for hospital-acquired AKI in older adults.
- To create a simplified scoring system, the Senior Hospitalized Adults' AKI Risk Prediction (SHARP) score.
Main Methods:
- Utilized data from hospitalized patients aged ≥65 years (2018-2020).
- Developed multivariable logistic regression models using LASSO and stepwise selection.
- Validated performance using AUC, calibration curves, and Hosmer-Lemeshow tests.
Main Results:
- The final model incorporated eight key risk factors, including heart failure, chronic kidney disease, and laboratory values.
- Achieved strong discrimination (AUC: 0.86-0.87) and good calibration.
- The SHARP score effectively stratified AKI risk, providing a median lead time for prediction.
Conclusions:
- The SHARP score offers a practical method for clinicians to assess AKI risk in hospitalized older patients.
- External validation is recommended to confirm the generalizability and predictive accuracy of the SHARP score.
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