External validation, recalibration, and clinical utility of the kidney failure risk equation in patients with advanced CKD: a nationwide retrospective cohort analysis in Peru.

ABSTRACT:

Background

The Kidney Failure Risk Equation (KFRE) is widely used for predicting kidney failure, but its external validity in Latin America is limited. A previous study in Peru found that KFRE was miscalibrated but did not evaluate its recalibration or clinical utility.

Methods

We conducted a retrospective cohort study using data from EsSalud's Renal Health Surveillance Program (2013-2022), including 30,031 patients with chronic kidney disease (CKD) stages G3-4. Kidney failure was defined by dialysis initiation or nephrologist-confirmed end-stage renal disease. Calibration was assessed using observed-to-expected (O/E) ratios and differences, calibration slope, and intercept, while discrimination was evaluated using the concordance index (C-index). Recalibrated models were de

SUBMITTER: Bravo-Zuniga JI 

PROVIDER: S-EPMC12679749 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature