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R Open Source Programming Code for Calculation of the Kidney Donor Profile Index and Kidney Donor Risk Index.

ABSTRACT: Background:The Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) were developed by the United States Organ Procurement and Transplantation Network (OPTN). They may influence the clinical decision whether to accept or discard a donor kidney, but still there are debates about KDPI/KDRI applicability and its consequences. To further evaluate these indexes in different populations, more data should be analyzed, and a universally applicable program code would facilitate it. Currently, KDPI/KDRI calculation could be readily done only on the OPTN website that is convenient for a single donor, but not suitable for processing data sets with many records. Summary:A universally applicable program algorithm in widely used R language for calculating KDPI and KDRI was developed according to donor factors and coefficients described in the OPTN guide. Key Messages:The open R code permits to calculate KDPI/KDRI either for a single donor or for an unlimited number of records in large data sets. The presented software code would save substantial time to research groups all over the world and help to clarify the KDPI/KDRI role in global settings.

SUBMITTER: Bikbov B

PROVIDER: S-EPMC6276747 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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R Open Source Programming Code for Calculation of the Kidney Donor Profile Index and Kidney Donor Risk Index.

Bikbov Boris B

Kidney diseases (Basel, Switzerland) 20180905 4

<h4>Background</h4>The Kidney Donor Profile Index (KDPI) and Kidney Donor Risk Index (KDRI) were developed by the United States Organ Procurement and Transplantation Network (OPTN). They may influence the clinical decision whether to accept or discard a donor kidney, but still there are debates about KDPI/KDRI applicability and its consequences. To further evaluate these indexes in different populations, more data should be analyzed, and a universally applicable program code would facilitate it. ...[more]

PMID: 30574504

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Project description:BackgroundThe Living Kidney Donor Profile Index (LKDPI) was derived in a cohort of kidney transplant recipients (KTR) from the United States to predict the risk of total graft failure. There are important differences in patient demographics, listing practices, access to transplantation, delivery of care, and posttransplant mortality in Canada as compared with the United States, and the generalizability of the LKDPI in the Canadian context is unknown.ObjectiveThe purpose of this study was to externally validate the LKDPI in a large contemporary cohort of Canadian KTR.DesignRetrospective cohort validation study.SettingToronto General Hospital, University Health Network, Toronto, Ontario, Canada.PatientsA total of 645 adult (≥18 years old) living donor KTR between January 1, 2006 and December 31, 2016 with follow-up until December 31, 2017 were included in the study.MeasurementsThe predictive performance of the LKDPI was evaluated. The outcome of interest was total graft failure, defined as the need for chronic dialysis, retransplantation, or death with graft function.MethodsThe Cox proportional hazards model was used to examine the relation between the LKDPI and total graft failure. The Cox proportional hazards model was also used for external validation and performance assessment of the model. Discrimination and calibration were used to assess model performance. Discrimination was assessed using Harrell's C statistic and calibration was assessed graphically, comparing observed versus predicted probabilities of total graft failure.ResultsA total of 645 living donor KTR were included in the study. The median LKDPI score was 13 (interquartile range [IQR] = 1.1, 29.9). Higher LKDPI scores were associated with an increased risk of total graft failure (hazard ratio = 1.01; 95% confidence interval [CI] = 1.0-1.02; P = .02). Discrimination was poor (C statistic = 0.55; 95% CI = 0.48-0.61). Calibration was as good at 1-year posttransplant but suboptimal at 3- and 5-years posttransplant.LimitationsLimitations include a relatively small sample size, predicted probabilities for assessment of calibration only available for scores of 0 to 100, and some missing data handled by imputation.ConclusionsIn this external validation study, the predictive ability of the LKDPI was modest in a cohort of Canadian KTR. Validation of prediction models is an important step to assess performance in external populations. Potential recalibration of the LKDPI may be useful prior to clinical use in external cohorts.

Dataset Information

R Open Source Programming Code for Calculation of the Kidney Donor Profile Index and Kidney Donor Risk Index.

Publications

R Open Source Programming Code for Calculation of the Kidney Donor Profile Index and Kidney Donor Risk Index.

Similar Datasets

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