Résumé
BackgroundThe Kidney Failure Risk Equation (KFRE) estimates the risk of kidney replacement therapy (KRT) at 5 years. Patients with diabetes mellitus are at high risk of KRT and death, a competing event. This study assesses the performance of the 5-year KFRE in patients with diabetes mellitus, compared to non-diabetic patients and considering age, in a cohort of patients evaluated by a nephrologist at a tertiary care center.MethodsThe CKD-CAREMEAU cohort included all patients who visited a nephrologist for chronic kidney disease (CKD) before KRT between 2008 and 2017. The 5-year KFRE was calculated for each patient, based on their baseline characteristics. The study evaluated performance regarding discrimination and calibration, taking the patient's diabetic status and age into account.ResultsThe study included 2935 patients with a median age of 73 [65-80] years, 1800 of whom were men (61%), and 1249 (43%) who were affected by diabetes. The incidence of KRT was higher in diabetic patients (167 (13%)) than in non-diabetic patients (184 (11%))(p = 0.04). Additionally, the death rate within five years after inclusion was not statistically higher for diabetic patients (351 (28%)) than non-diabetic patients (443 (26%))(p = 0.3). Diabetic status affected neither discrimination nor calibration. However, the equation overestimated the risk for higher-risk patients, especially among the elderly.ConclusionsOur study found no difference in the 5-year KFRE performance between diabetic and non-diabetic patients. However, performance was worse for patients over 75 years old.