Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data

Background Frailty predicts poor outcomes in chronic kidney disease (CKD) patients. This study compared frailty’s predictive power with other factors and aimed to develop a model for predicting overall survival (OS) in CKD patients.Methods The study included 3,714 CKD participants from the National...

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Main Authors: Ting Li, Zaoqiang Lin, Zeyong Tang, Liuchang Feng, Nuo Lei, Hui Chen, Guozi Chen, Qinxiang Tan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2476740
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author Ting Li
Zaoqiang Lin
Zeyong Tang
Liuchang Feng
Nuo Lei
Hui Chen
Guozi Chen
Qinxiang Tan
author_facet Ting Li
Zaoqiang Lin
Zeyong Tang
Liuchang Feng
Nuo Lei
Hui Chen
Guozi Chen
Qinxiang Tan
author_sort Ting Li
collection DOAJ
description Background Frailty predicts poor outcomes in chronic kidney disease (CKD) patients. This study compared frailty’s predictive power with other factors and aimed to develop a model for predicting overall survival (OS) in CKD patients.Methods The study included 3,714 CKD participants from the National Health and Nutrition Examination Survey 2005–2018. The death data were updated to December 31, 2019. Lasso-Cox regression identified significant predictors among 42 factors, resulting in a prognostic nomogram using 11 key variables. Subsequent evaluation of the nomogram involved the C-index, the Areas Under Time-dependent Receiver Operating Characteristic Curves (AUC) and calibration curves.Results Over a median follow-up of 5.92 years, 1,234 deaths occurred. The final predictors of OS in CKD patients included age, ethnicity, smoking status, estimated pulse wave velocity, body fat percentage, blood uric acid concentration, blood urea nitrogen concentration, and albumin concentration, neutrophil-to-lymphocyte ratio, urine albumin-to-creatinine ratio level, and frailty index (FI) score. The FI score was the strongest predictor with an HR of 76.54 (95% CI: 42.93, 136.46, p < 0.0001). In the training set, the AUC values were 80.11% for 1-year, 79.90% for 3-year, 79.53% for 5-year, and 81.34% for 10-year follow-ups. In the internal validation set, AUC values were 78.66%, 77.78%, 77.56%, and 79.54%, respectively. The nomogram’s corrected C-index was 0.76 (95% CI: 0.75 − 0.78), and calibration curves showed satisfactory accuracy.Conclusions The FI score is a significant predictor of CKD OS. The developed nomogram based on the FI score is a promising tool for predicting the OS of CKD patients.
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series Renal Failure
spelling doaj-art-659cf9f5ace34f1b8e4dbf0d511b2fbf2025-08-20T02:18:42ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2476740Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES dataTing Li0Zaoqiang Lin1Zeyong Tang2Liuchang Feng3Nuo Lei4Hui Chen5Guozi Chen6Qinxiang Tan7Department of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaDepartment of Nephrology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, ChinaBackground Frailty predicts poor outcomes in chronic kidney disease (CKD) patients. This study compared frailty’s predictive power with other factors and aimed to develop a model for predicting overall survival (OS) in CKD patients.Methods The study included 3,714 CKD participants from the National Health and Nutrition Examination Survey 2005–2018. The death data were updated to December 31, 2019. Lasso-Cox regression identified significant predictors among 42 factors, resulting in a prognostic nomogram using 11 key variables. Subsequent evaluation of the nomogram involved the C-index, the Areas Under Time-dependent Receiver Operating Characteristic Curves (AUC) and calibration curves.Results Over a median follow-up of 5.92 years, 1,234 deaths occurred. The final predictors of OS in CKD patients included age, ethnicity, smoking status, estimated pulse wave velocity, body fat percentage, blood uric acid concentration, blood urea nitrogen concentration, and albumin concentration, neutrophil-to-lymphocyte ratio, urine albumin-to-creatinine ratio level, and frailty index (FI) score. The FI score was the strongest predictor with an HR of 76.54 (95% CI: 42.93, 136.46, p < 0.0001). In the training set, the AUC values were 80.11% for 1-year, 79.90% for 3-year, 79.53% for 5-year, and 81.34% for 10-year follow-ups. In the internal validation set, AUC values were 78.66%, 77.78%, 77.56%, and 79.54%, respectively. The nomogram’s corrected C-index was 0.76 (95% CI: 0.75 − 0.78), and calibration curves showed satisfactory accuracy.Conclusions The FI score is a significant predictor of CKD OS. The developed nomogram based on the FI score is a promising tool for predicting the OS of CKD patients.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2476740Chronic kidney Diseasefrailtyoverall survivalLasso-Cox analysisnomogram
spellingShingle Ting Li
Zaoqiang Lin
Zeyong Tang
Liuchang Feng
Nuo Lei
Hui Chen
Guozi Chen
Qinxiang Tan
Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
Renal Failure
Chronic kidney Disease
frailty
overall survival
Lasso-Cox analysis
nomogram
title Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
title_full Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
title_fullStr Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
title_full_unstemmed Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
title_short Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data
title_sort chronic kidney disease overall survival prediction model based on frailty index score construction and validation using nhanes data
topic Chronic kidney Disease
frailty
overall survival
Lasso-Cox analysis
nomogram
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2476740
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