Nomograms May Help Predict Kidney Transplant Outcomes

[okarol]

Nomograms May Help Predict Kidney Transplant Outcomes
Model performed well for predicting five-year graft survival, based on pre-transplant information
Jan 26, 2009

MONDAY, Jan. 26 (HealthDay News) -- A set of nomograms may be helpful in predicting renal function and graft survival in living donor kidney transplantation, according to research published online Jan. 23 in the Journal of Urology.

H.Y. Tiong, M.D., of the Cleveland Clinic in Cleveland, Ohio, and colleagues used data from 20,085 living donor renal transplant cases from 2000 to 2003 to construct three nomograms. One predicted one-year estimated glomerular filtration rate (eGFR), one predicted five-year graft survival using pre-transplant information, and one predicted five-year graft survival using more information available after transplantation.

The renal function nomogram had a modest prediction ability, with an r-square value of 0.13, the researchers report. According to the authors, it functioned best when predicting eGFR values between 50 and 70 milliliters per minute per 1.73 m2. The nomogram for predicting graft survival with pre-transplant information performed well, with a concordance index of 0.71. The six-month post-transplant nomogram had a concordance index of 0.78, the investigators found. Factors in these models included recipient and donor age, race, gender, body mass index, donor serum creatinine, and cause of renal failure.

"A theoretical concern is the potential for abuse of the nomograms when they are used to select potential donors because recipients may be encouraged to shop around for the best possible donor," the authors write. "The reality may be that few recipients have the luxury of multiple donors. Ultimately, transplant physicians should retain clinical judgment with the help of these nomograms to counsel their patients because there are other factors such as patient compliance which can impact outcomes but are difficult to characterize."

Abstract http://www.jurology.com/article/S0022-5347(08)03012-7/abstract

Full Text http://www.jurology.com/article/PIIS0022534708030127/fulltext

http://www.modernmedicine.com/modernmedicine/Pathology/Nomograms-May-Help-Predict-Kidney-Transplant-Outco/ArticleNewsFeed/Article/detail/577547?contextCategoryId=40137