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Prediction of risk of death for patients starting dialysis: A systematic review and meta-analysis

Clinical Journal of the American Society of Nephrology Aug 03, 2019

Anderson RT, Cleek H, Pajouhi AS, et al. - By analyzing 36 studies reporting validated prognostic indices predicting death at the commencement of dialysis, researchers assessed the performance of prognostic indices for patients initiating dialysis to aid bedside translation, given that patients desire risk prediction. These studies were identified from Ovid MEDLINE, Ovid Embase, Ovid Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Investigations restricted to prevalent dialysis patients, AKI and reports excluding death in the first 1–3 months were dismissed. Overall 32 prognostic indices were described. For The Obi, Ivory, and Charlson comorbidity index (CCI), the highest area under the curve (AUC) (0.74) was demonstrated by a meta-analysis by index. The most commonly used was CCI (ten studies). Kahn-Wright index (eight studies, AUC 0.68), Hemmelgarn modification of the CCI (six studies, AUC 0.66) and REIN index (five studies, AUC 0.69) were identified as other commonly used indices. Ten of the overall indices had received external validation and 16 were internally validated, and 9 were preexisting validated indices. For predicting survival at dialysis commencement, the availability of several well-validated indices with good discrimination was highlighted.
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