External validation of yonsei nomogram predicting chronic kidney disease development after partial nephrectomy: An international, multicenter study.

To externally validate Yonsei nomogram.

From 2000 through 2018, 3526 consecutive patients underwent on-clamp PN for cT1 renal masses at 23 centers were included. All patients had two kidneys, preoperative eGFR ≥60 ml/min/1. 73 m2, and a minimum follow-up of 12 months. New-onset CKD was defined as upgrading from CKD stage I or II into CKD stage ≥III. We obtained the CKD-free progression probabilities at 1, 3, 5, and 10 years for all patients by applying the nomogram found at https://eservices.ksmc.med.sa/ckd/. Thereafter, external validation of Yonsei nomogram for estimating new-onset CKD stage ≥III was assessed by calibration and discrimination analysis.

Median values of patients' age, tumor size, eGFR and follow-up period were 47 years (IQR: 47-62), 3.3 cm (IQR: 2.5-4.2), 90.5 ml/min/1.73 m2 (IQR: 82.8-98), and 47 months (IQR: 27-65), respectively. A total of 683 patients (19.4%) developed new-onset CKD. The 5-year CKD-free progression rate was 77.9%. Yonsei nomogram demonstrated an AUC of 0.69, 0.72, 0.77, and 0.78 for the prediction of CKD stage ≥III at 1, 3, 5, and 10 years, respectively. The calibration plots at 1, 3, 5, and 10 years showed that the model was well calibrated with calibration slope values of 0.77, 0.83, 0.76, and 0.75, respectively. Retrospective database collection is a limitation of our study.

The largest external validation of Yonsei nomogram showed good calibration properties. The nomogram can provide an accurate estimate of the individual risk of CKD-free progression on long-term follow-up.

International journal of urology : official journal of the Japanese Urological Association. 2022 Dec 07 [Epub ahead of print]

Ali Abdel Raheem, Isotta Landi, Ibrahim Alowidah, Umberto Capitanio, Francesco Montorsi, Alessandro Larcher, Ithaar Derweesh, Fady Ghali, Alexander Mottrie, Elio Mazzone, Geert De Naeyer, Riccardo Campi, Francesco Sessa, Marco Carini, Andrea Minervini, Jay D Raman, Chris J Rjepaj, Maximilian C Kriegmair, Riccardo Autorino, Alessandro Veccia, Maria Carmen Mir, Francesco Claps, Young Deuk Choi, Won Sik Ham, Glen Denmer Santok, John Paul Tadifa, Justin Syling, Maria Furlan, Claudio Simeone, Maida Bada, Antonio Celia, Diego M Carrión, Alfredo Aguilera Bazan, Cristina Ballesteros Ruiz, Manar Malki, Neil Barber, Muddassar Hussain, Salvatore Micali, Stefano Puliatti, Ahmed Ghaith, Ayman Hagras, Ayman M Ghoneem, Ahmed Eissa, Abdulrahman Alqahtani, Abdullah Rumaih, Abdelaziz Alwahabi, Mohammed Jayed Alenzi, Nicola Pavan, Fabio Traunero, Alessandro Antonelli, Antonio Benito Porcaro, Ester Illiano, Elisabetta Costantini, Koon Ho Rha

Department of Urology, King Saud Medical City, Riyadh, Saudi Arabia., Center for Neuroscience and Cognitive Systems at University of Trento, Italian Institute of Technology, Rovereto, Italy., Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy., Department of Urology, UC San Diego School of Medicine, La Jolla, California, USA., Department of Urology, OLV Hospital, Aalst, Belgium., Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, University of Florence, Florence, Italy., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Department of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA., Department of Urology, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany., Division of Urology, VCU Health, Richmond, Virginia, USA., Department of Urology, Fundación Instituto Valenciano Oncología, Valencia, Spain., Department of Urology, Yonsei University College of Medicine, Seoul, South Korea., Department of Urology, National Kidney and Transplant Institute, Metro Manila, Philippines., Department of Urology, ASST-Spedali Civili, Brescia, Italy., Department of Urology, Hospital S. Bassiano, Bassano del Grappa (VI), Vicenza, Italy., Department of Urology, Torrejon University Hospital, Madrid, Spain., Department of Urology, La Paz University Hospital, Madrid, Spain., Firmley Renal Cancer Centre, Centre Frimley Park Hospital, Surrey, Firmley, UK., Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt., Department of Urology unit, Al-Jouf University, Al-Jouf, Saudi Arabia., Urology Clinic, Department of Medical, Surgical and Health Sciences, Cattinara Hospital, University of Trieste, Trieste, Italy., Department of Urology, AOUI Verona, University of Verona, Verona, Italy., Andrological and Urogynecological Clinic, Santa Maria Terni Hospital, University of Perugia, Perugia, Italy.