Zelt JGE, Hossain A, Sun LY, et al. - In view of the significance of risk assessment for prognostication and individualized treatment decisions for patients with pulmonary arterial hypertension (PAH), researchers here compared contemporary risk assessment tools for patients with PAH. Further, they investigated the prognostic significance of risk parameters of kidney function and if they can further improve risk prediction in these patients. A cohort of treatment naïve PAH patients (n = 211) at the University of Ottawa Heart Institute was categorized as low, intermediate or high risk according to current European guidelines (ESC) and REVEAL risk scores. Outcomes revealed both the ESC and REVEAL algorithms as valuable for stratification of transplant-free survival risk, however, the REVEAL score led to superior dicrimination. Novel risk parameters identified were renal function at diagnosis and ∆renal function at 6 months; these may allow reclassification of some patients in the ‘intermediate risk’ category to a ‘lower or higher risk’ strata.