An illustrative model application: 5-year risk of adverse outcomes in selected patients
| Patient profile (see footnote for complete profiles) | Major vascular event or vascular death | Renal replacement therapy | Vascular death | Death from any cause* |
| Heterogeneity among patients in the same CKD stage | ||||
| Fifty-year-old male in CKD stage 4, with cystic kidney disease, and no comorbidities† | 7% (5%–9%) | 65% (58%–72%) | 2% (1%–2%) | 9% (8%–10%) |
| Seventy-year-old male in CKD stage 4, with diabetic nephropathy and cardiovascular disease‡ | 49% (40%–59%) | 14% (11%–18%) | 15% (10%–23%) | 27% (23%–34%) |
| Initiation of renal replacement therapy: comparison of outcomes for patients on dialysis versus those on kidney transplant | ||||
| Sixty-year-old female without comorbidities following initiation of dialysis§ | 12% (10%–14%) | NA | 4% (3%–6%) | 33% (31%–34%) |
| Sixty-year-old female without comorbidities following successful kidney transplant¶ | 5% (3%–7%) | NA | 1% (1%–2%) | 13% (13%–14%) |
*UK population data used to derive annual non-vascular mortality rates in the model (Table SM2), †Patient profiles: 50 years old; male; white; postsecondary education; adult dependants; never smoker; BMI: 25–29 kg/m2; diastolic blood pressure≥85 mm Hg; systolic blood pressure<130 mm Hg; HDL cholesterol<0.9 mmol/L; albumin: 3.9–4.1 g/dL; haemoglobin≥13 g/dL; phosphate 1.2–1.4 mmol/L; uACR: 30–300 mg/g; no vascular disease; no diabetes mellitus; CKD stage 4; 30 years since CKD diagnosis; cystic kidney disease, ‡Seventy years old; male; white; completed secondary education; no adult dependants; current smoker; BMI≥30 kg/m2; diastolic blood pressure<75 mm Hg; systolic blood pressure:<130 mm Hg; HDL cholesterol<0.9 mmol/L; albumin≥4.2 g/dL; haemoglobin≥13 g/dL; phosphate<1.2 mmol/L; ACR: 30–300 mg/g; vascular disease; diabetes mellitus; CKD stage 4; 20 years since CKD diagnosis; diabetic nephropathy, §Sixty years old; female; white; completed secondary education; adult dependants; never smoker; BMI<25 kg/m2; diastolic blood pressure: 75–84 mm Hg; systolic blood pressure: 130–149 mm Hg; HDL cholesterol: 0.9–1.1 mmol/L; albumin: 3.9–4.1 g/dL; haemoglobin: 11.6–12.9 g/dL; phosphate≥1.5 mmol/L; no previous vascular disease; no diabetes mellitus; initiating dialysis; 5 years since CKD diagnosis; no cystic kidney disease or diabetic nephropathy, ¶Same as profile 3 but following successful kidney transplant.
CKD, chronic kidney disease; RRT, renal replacement therapy; BMI, body mass index; uACR, urinary albumin-to-creatinine ratio.