{"doi":"10.1016/j.ekir.2022.01.1067","title":"Prediction of Incident Heart Failure in CKD: The CRIC Study","abstract":"IntroductionHeart failure (HF) is common in chronic kidney disease (CKD); identifying patients with CKD at high risk for HF may guide clinical care. We assessed the prognostic value of cardiac biomarkers and echocardiographic variables for 10-year HF prediction compared with a published clinical HF prediction equation in a cohort of participants with CKD.MethodsWe studied 2147 Chronic Renal Insufficiency Cohort (CRIC) participants without prior HF with complete clinical, cardiac biomarker (N-terminal brain natriuretic peptide [NT-proBNP] and high sensitivity troponin-T [hsTnT]), and echocardiographic data (left ventricular mass [LVM] and left ventricular ejection fraction [LVEF] data). We compared the discrimination of the 11-variable Atherosclerosis Risk in Communities (ARIC) HF prediction equation with LVM, LVEF, hsTnT, and NT-proBNP to predict 10-year risk of hospitalization for HF using a Fine and Gray modeling approach. We separately evaluated prediction of HF with preserved and reduced LVEF (LVEF ≥50% and <50%, respectively). We assessed discrimination with internally valid C-indices using 10-fold cross-validation.ResultsParticipants’ mean (SD) age was 59 (11) years, 53% were men, 43% were Black, and mean (SD) estimated glomerular filtration rate (eGFR) was 44 (16) ml/min per 1.73 m2. A total of 324 incident HF hospitalizations occurred during median (interquartile range) 10.0 (5.7–10.0) years of follow-up. The ARIC HF model with clinical variables had a C-index of 0.68. Echocardiographic variables predicted HF (C-index 0.70) comparably to the published ARIC HF model, while NT-proBNP and hsTnT together (C-index 0.73) had significantly better discrimination (P = 0.004). A model including cardiac biomarkers, echocardiographic variables, and clinical variables had a C-index of 0.77. Discrimination of HF with preserved LVEF was lower than for HF with reduced LVEF for most models.ConclusionThe ARIC HF prediction model for 10-year HF risk had modest discrimination among adults with CKD. NT-proBNP and hsTnT discriminated better than the ARIC HF model and at least as well as a model with echocardiographic variables. HF clinical prediction models tailored to adults with CKD are needed. Until then, measurement of NT-proBNP and hsTnT may be a low-burden approach to predicting HF in this population, as they offer moderate discrimination.","journal":"Kidney International Reports","year":2022,"id":244346,"datarank":0.519860385419959,"base_score":3.4657359027997265,"endowment":3.4657359027997265,"self_citation_contribution":0.519860385419959,"citation_network_contribution":0.0,"self_endowment_contribution":0.519860385419959,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9376,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":19396,"name":"Michael G. Shlipak","orcid":"0000-0002-9559-204X","position":1,"is_corresponding":false},{"id":55719,"name":"Elsayed Z. Soliman","orcid":"0000-0001-5632-8150","position":2,"is_corresponding":false},{"id":261902,"name":"Amanda H. Anderson","orcid":"0000-0002-1454-4282","position":3,"is_corresponding":false},{"id":479551,"name":"Robert H. Christenson","orcid":"0000-0003-2612-9083","position":4,"is_corresponding":false},{"id":332044,"name":"Mayank Kansal","orcid":"0000-0003-2552-8744","position":5,"is_corresponding":false},{"id":108266,"name":"Rajat Deo","orcid":"0000-0002-8250-2607","position":6,"is_corresponding":false},{"id":24759,"name":"Jiang He","orcid":"0000-0002-8286-9652","position":7,"is_corresponding":false},{"id":337717,"name":"Bernard G. Jaar","orcid":"0000-0003-1210-7115","position":8,"is_corresponding":false},{"id":244987,"name":"Matthew R. Weir","orcid":"0000-0001-8820-5702","position":9,"is_corresponding":false},{"id":277170,"name":"Panduranga S. Rao","orcid":"0000-0002-4699-5395","position":10,"is_corresponding":false},{"id":283063,"name":"Debbie L. Cohen","orcid":"0000-0002-1325-315X","position":11,"is_corresponding":false},{"id":228812,"name":"Jordana B. Cohen","orcid":"0000-0003-4649-079X","position":12,"is_corresponding":false},{"id":58429,"name":"Harold I. Feldman","orcid":"0000-0003-4572-2608","position":13,"is_corresponding":false},{"id":249669,"name":"Alan S. Go","orcid":"0000-0001-9109-0811","position":14,"is_corresponding":false},{"id":54242,"name":"Nisha Bansal","orcid":"0000-0002-9583-8628","position":15,"is_corresponding":false},{"id":277163,"name":"Lawrence J. Appel","orcid":"0000-0002-0673-6823","position":16,"is_corresponding":false},{"id":261903,"name":"Jing Chen","orcid":"0000-0002-9035-9126","position":17,"is_corresponding":false},{"id":277166,"name":"James P. Lash","orcid":"0000-0002-6580-4080","position":21,"is_corresponding":false},{"id":68431,"name":"Robert G. Nelson","orcid":"0000-0001-7307-3786","position":22,"is_corresponding":false},{"id":277171,"name":"Mahboob Rahman","orcid":"0000-0001-9025-7413","position":23,"is_corresponding":false},{"id":277172,"name":"Vallabh O. Shah","orcid":"0000-0002-3584-4057","position":25,"is_corresponding":false},{"id":277173,"name":"Mark L. Unruh","orcid":"0000-0001-7103-656X","position":26,"is_corresponding":false},{"id":255634,"name":"Leila R. Zelnick","orcid":"0000-0002-8461-5111","position":0,"is_corresponding":true}],"reference_count":67,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:23:25.718788Z","pmid":"35497796","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}