Simple risk score, including nine covariates, predicted risk for CP-AKI in monotonic manner in derivation, validation cohorts
By Elana Gotkine HealthDay Reporter
WEDNESDAY, March 27, 2024 (HealthDay News) — A simple risk score consisting of nine covariates predicts the risk for severe cisplatin-associated acute kidney injury (CP-AKI), according to a study published online March 27 in The BMJ.
Shruti Gupta, M.D., from Brigham and Women’s Hospital in Boston, and colleagues developed and externally validated a prediction model for severe CP-AKI in a multicenter cohort study involving adults receiving their first dose of intravenous cisplatin in 2006 to 2022. Independent predictors of CP-AKI were identified using a multivariable logistic regression model, which was developed and tested in a derivation cohort (11,766 adults) and an external validation cohort (12,951 adults).
The researchers found that the incidence of CP-AKI was 5.2 and 3.3 percent in the derivation and validation cohorts, respectively. Age, hypertension, diabetes mellitus, serum creatinine level, hemoglobin level, white blood cell count, platelet count, serum albumin level, serum magnesium level, and cisplatin dose were independently associated with CP-AKI. A simple risk score composed of nine covariates predicted a higher risk for CP-AKI in a monotonic manner in the derivation and validation cohorts. Patients in the highest- versus the lowest-risk category had 24.00- and 17.87-fold increased odds in the derivation and validation cohorts, respectively. The C-statistic for the primary model was 0.75, and it showed better discrimination than previously published models (range, 0.60 to 0.68). A monotonic association was seen for greater severity of CP-AKI with shorter 90-day survival (adjusted hazard ratio, 4.63 for stage 3 versus no CP-AKI).
“This model should help providers weigh the risks and benefits of cisplatin and will allow for enrichment of prospective studies designed to prevent CP-AKI,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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