Onur Potok|Hoang Anh Nguyen|Joseph A. Abdelmalek|Tomasz Beben|Tyler B. Woodell|Dena E. Rifkin
Patients,’ Nephrologists,’ and Predicted Estimations of ESKD Risk Compared with 2-Year Incidence of ESKD
University of California, San Diego|University of California, Irvine|University of California, San Diego|VA San Diego Healthcare System|University of California, San Diego|VA San Diego Healthcare System|University of California, San Diego|University of California, San Diego|VA San Diego Healthcare System
rate progression eskd variable prognostic information helps patients physicians plan future eskd assessed estimations eskd risk patients ckd physicians compared risk calculators outcomes 2 yearsthis prospective observational study assessed 257 adult patients ckd stages 35 nephrologists university california san diego veterans affairs san diego ckd clinics patients nephrologists estimations 2year eskd risk evaluated objective estimation 2year risk determined using kidney failure risk equations actual incidence rates eskd death ascertained chart review participants baseline characteristics compared across kidney failure risk equation risk levels according whether patients estimations optimistic pessimistic physicians estimations examined correlations estimations compared estimations outcomes using c statistics calibration plotsaverage age 65 13 years old egfr 34 13 mlmin per 173 m2 overall 13 reached eskd 9 died one quarter patients gave estimates 20 optimistic physicians one ten gave estimates 20 pessimistic physicians kidney failure risk equation estimations strongest correlation r072 p0001 compared 050 p0001 physicians patients 047 p0001 patients kidney failure risk equation although three estimations provided reasonable risk rankings c statistics 08 physicians patients overestimated risk compared actual outcomes patient whose physician estimated risk eskd 15 reached eskd 2 years kidney failure risk equation best calibrated actual eskd riskcompared actual eskd incidence kidney failure risk equation outperformed patients physicians estimations eskd incidence patients physicians overestimated risk compared kidney failure risk equation