Validity of Cardiovascular Risk Prediction Models in Kidney Transplant Recipients

Overview

Journal ScientificWorldJournal

Publisher Wiley

Specialty Biology

Date 2014 Jul 1

PMID 24977223

Citations 13

Authors

Holly Mansell

Samuel Alan Stewart

Ahmed Shoker

Affiliations

Soon will be listed here.

Abstract

Background: Predicting cardiovascular risk is of great interest in renal transplant recipients since cardiovascular disease is the leading cause of mortality.

Objective: To conduct a systematic review to assess the validity of cardiovascular risk prediction models in this population.

Methods: Five databases were searched (MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science) and cohort studies with at least one year of follow-up were included. Variables that described population characteristics, study design, and prognostic performance were extracted. The Quality in Prognostic Studies (QUIPS) tool was used to evaluate bias.

Results: Seven studies met the criteria for inclusion, of which, five investigated the Framingham risk score and three used a transplant-specific model. Sample sizes ranged from 344 to 23,575, and three studies lacked sufficient event rates to confidently reach conclusion. Four studies reported discrimination (as measured by c-statistic), which ranged from 0.701 to 0.75, while only one risk model was both internally and externally validated.

Conclusion: The Framingham has underestimated cardiovascular events in renal transplant recipients, but these studies have not been robust. A risk prediction model has been externally validated at least on one occasion, but comprehensive validation in multiple cohorts and impact analysis are recommended before widespread clinical application is advocated.

Citing Articles

A structured, home-based exercise programme in kidney transplant recipients (ECSERT): A randomised controlled feasibility study.

Billany R, Macdonald J, Burns S, Chowdhury R, Ford E, Mubaarak Z PLoS One. 2025; 20(2):e0316031.

PMID: 39992959 PMC: 11849866. DOI: 10.1371/journal.pone.0316031.

Dyslipidemia in Transplant Patients: Which Therapy?.

Iannuzzo G, Cuomo G, Di Lorenzo A, Tripaldella M, Mallardo V, Iaccarino Idelson P J Clin Med. 2022; 11(14).

PMID: 35887846 PMC: 9318180. DOI: 10.3390/jcm11144080.

Influence of Belatacept- vs. CNI-Based Immunosuppression on Vascular Stiffness and Body Composition.

Heleniak Z, Illersperger S, Naik M, Osmanodja B, Ronicke S, Eleftheriadis G J Clin Med. 2022; 11(5).

PMID: 35268310 PMC: 8911184. DOI: 10.3390/jcm11051219.

Risk of post-transplant cardiovascular events in kidney transplant recipients with preexisting aortoiliac stenosis.

Babakry S, Rijkse E, Roodnat J, Bijdevaate D, IJzermans J, Minnee R Clin Transplant. 2021; 36(1):e14515.

PMID: 34674329 PMC: 9285727. DOI: 10.1111/ctr.14515.

A pilot randomised controlled trial of a structured, home-based exercise programme on cardiovascular structure and function in kidney transplant recipients: the ECSERT study design and methods.

Billany R, Vadaszy N, Bishop N, Wilkinson T, Adenwalla S, Robinson K BMJ Open. 2021; 11(10):e046945.

PMID: 34610929 PMC: 8493915. DOI: 10.1136/bmjopen-2020-046945.

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