PMID- 17276995
OWN - NLM
STAT- MEDLINE
DCOM- 20070809
LR  - 20191210
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 22
IP  - 5
DP  - 2007 May
TI  - Prognostic value of the New York Heart Association classification in end-stage 
      renal disease.
PG  - 1377-82
AB  - BACKGROUND: The New York Heart Association (NYHA) classification is a strong 
      predictor of mortality and an established instrument for risk stratification in 
      patients with heart disease but data on the validity of this classification in 
      end-stage renal disease (ESRD) are sparse. METHODS: In this study, we tested the 
      predictive value of the NYHA in patients with ESRD and compared it with that of 
      two established indexes of disease severity, i.e. the Khan index and the renal 
      disease severity score (RDSS). The study cohort was composed of 1322 incident 
      patients in a dialysis registry (772 male and 550 female, age 61+/-16 years). 
      RESULTS: During the follow-up period (41+/-27 months) 551 patients died. A 
      multivariate COX model including the NYHA classification explained 39% of the 
      variation in mortality, a figure almost identical to that of a model based on the 
      RDSS (37%) and superior (P<0.001) to that provided by the Khan index-based model 
      (32%). The area under the receiver operating characteristic curve of NYHA 
      classification, as related to all-cause mortality, was 0.74 (95% CI: 0.71-0.77, 
      P<0.001). Again, RDSS had a predictive value for mortality (0.74, 95% CI: 
      0.72-0.77) identical to that of NYHA and higher than that of the Khan index 
      (0.70, 95% CI: 0.67-0.72). CONCLUSION: The NYHA is a powerful predictor of 
      mortality in ESRD and provides prognostic information equal or superior to that 
      given by other established indexes of disease severity. Given the pervasive 
      nature of cardiovascular disease in ESRD, this classification may be recommended 
      for risk stratification in this population.
FAU - Postorino, Maurizio
AU  - Postorino M
AD  - CNR-IBIM Istituto di Biomedicina - Consiglio Nazionale delle Ricerche c/o 
      Divisione di Nefrologia e Dialisi Ospedali Riuniti - 89100 Reggio Calabria, 
      Italy. carmine.zoccali@tin.it.
FAU - Marino, Carmen
AU  - Marino C
FAU - Tripepi, Giovanni
AU  - Tripepi G
FAU - Zoccali, Carmine
AU  - Zoccali C
CN  - Calabrian Registry of Dialysis and Transplantation
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Validation Study
DEP - 20070201
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Italy
MH  - Kaplan-Meier Estimate
MH  - Kidney Failure, Chronic/*classification/mortality/*pathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Registries
MH  - *Severity of Illness Index
EDAT- 2007/02/06 09:00
MHDA- 2007/08/10 09:00
CRDT- 2007/02/06 09:00
PHST- 2007/02/06 09:00 [pubmed]
PHST- 2007/08/10 09:00 [medline]
PHST- 2007/02/06 09:00 [entrez]
AID - gfl813 [pii]
AID - 10.1093/ndt/gfl813 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2007 May;22(5):1377-82. doi: 10.1093/ndt/gfl813. Epub 
      2007 Feb 1.