Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Dynamic predictions of long-term kidney graft failure: an information tool promoting patient-centred care.

Marie-Cécile Fournier 1, 2 Yohann Foucher 2, 3 Paul Blanche 4, 5 Christophe Legendre 6 Sophie Girerd 7 Marc Ladrière 7 Emmanuel Morélon 8 Fanny Buron 8 Lionel Rostaing 9 Nassim Kamar 10 Georges Mourad 11, 12 Valérie Garrigue 11 Grégoire Couvrat-Desvergnes 13, 1 Magali Giral 1, 14 Etienne Dantan 2
1 U1064 Inserm - CRTI - Centre de Recherche en Transplantation et Immunologie
2 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
3 CHU Nantes - Centre hospitalier universitaire de Nantes
4 LMBA - Laboratoire de Mathématiques de Bretagne Atlantique
5 Copenhagen University Hospital
6 CHU Necker - Enfants Malades [AP-HP]
7 Service de Néphrologie [CHRU Nancy]
8 Hôpital Edouard Herriot [CHU - HCL]
9 Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation
10 I2MR - Institut de médecine moléculaire de Rangueil
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)
13 ITUN - Institut de transplantation urologie-néphrologie
14 CIC biothérapies CBT 0503 [Nantes]
Abstract : Background: Informing kidney transplant recipients of their prognosis and disease progression is of primary importance in a patient-centred vision of care. By participating in decisions from the outset, transplant recipients may be more adherent to complex medical regimens due to their enhanced understanding. Methods: We proposed to include repeated measurements of serum creatinine (SCr), in addition to baseline characteristics, in order to obtain dynamic predictions of the graft failure risk that could be updated continuously during patient follow-up. Adult recipients from the French Données Informatisées et VAlidées en Transplantation (DIVAT) cohort transplanted for the first or second time from a heart-beating or living donor and alive with a functioning graft at 1 year post-transplantation were included. Results: The model was composed of six baseline parameters, in addition to the SCr evolution. We validated the dynamic predictions by evaluating both discrimination and calibration accuracy. The area under the receiver operating characteristic curve varied from 0.72 to 0.76 for prediction times at 1 and 6 years post-transplantation, respectively, while calibration plots showed correct accuracy. We also provided an online application tool (https://shiny.idbc.fr/DynPG). Conclusion: We have created a tool that, for the first time in kidney transplantation, predicts graft failure risk both at an individual patient level and dynamically. We believe that this tool would encourage willing patients into participative medicine.
Keywords : Dynamic prediction Graft failure Kidney transplantation Patient-centred care Shared decision-making
Type de document :
Article dans une revue
Liste complète des métadonnées
https://hal.umontpellier.fr/hal-02880213
Contributeur : Nathalie Salvy-Cordoba Connectez-vous pour contacter le contributeur
Soumis le : mardi 21 septembre 2021 - 18:07:06
Dernière modification le : lundi 11 octobre 2021 - 14:23:10

Fichier

Vignette du document
Final author version.pdf
Fichiers produits par l'(les) auteur(s)

Identifiants

Collections

UNIV-NANTES | UNIV-MONTPELLIER | UBS | LMBA_UBS | CHL | BS | SPHERE_HEALTH_RESEARCH | CRTI | IBNM | HEH | UNIV-BREST | HCL | UNIV-TLSE3 | UNIV-TOURS | CNRS | INSERM

Citation

Marie-Cécile Fournier, Yohann Foucher, Paul Blanche, Christophe Legendre, Sophie Girerd, et al.. Dynamic predictions of long-term kidney graft failure: an information tool promoting patient-centred care.. Nephrology Dialysis Transplantation, Oxford University Press (OUP), 2019, 34 (11), pp.1961-1969. ⟨10.1093/ndt/gfz027⟩. ⟨hal-02880213⟩

Exporter

BibTeX TEI DC DCterms EndNote

Partager

Métriques

Consultations de la notice

326

Téléchargements de fichiers

118