Chronic kidney disease (CKD) is highly prevalent in the general population. It leads to increased cardiovascular disease (CVD) risk and, conversely, cardiovascular events may accelerate kidney disease progression. The Study of Heart and Renal Protection (SHARP) CKD-CVD model simulates this interdependence for individual patients’ risk profiles, and projects lifetime cardiovascular events, kidney disease progression, (quality-of-life adjusted) survival and healthcare costs.
Individual patient-level data from the 9,300 participants with moderate-to-advanced CKD followed for an average of five years in SHARP were used to develop, in collaboration with SHARP clinicians and epidemiologists, the multi-state SHARP CKD-CVD decision-analytic model. Separate sub-models were developed for kidney disease progression and for cardiovascular events and mortality through a series of risk equations estimated using SHARP participants’ demographic, lifestyle and clinical characteristics and up-to-date kidney disease and cardiovascular event histories. Model performance was assessed using three external patient cohorts.
A detailed description of the SHARP CKD-CVD model, including two illustrative applications, was recently published in Heart. To facilitate model use, a user-friendly web interface with a detailed user guide is freely available at http://dismod.ndph.ox.ac.uk/kidneymodel/app/. The model allows the user to predict outcomes for individual patients and groups of patients as well as to simulate outcomes with additional cardiovascular interventions. The model is fully parameterised for the UK setting, including parameter uncertainty, and is adaptable to other settings.
We hope that the SHARP CKD-CVD model will be useful to analysts and policy makers to evaluate kidney disease patients’ prospects and the (cost-) effectiveness of interventions to reduce cardiovascular risk, as well as to clinicians to estimate their CKD patients’ risks and guide treatment discussions. Read more