QRISK-3 cardiovascular risk assessment algorithm in prediction of kidney transplantation outcomes

Introduction. Cardiovascular complications are the leading cause of mortality among kidney recipients. Moreover, cardiovascular risk is associated with kidney transplant outcomes. Objective. To justify the QRISK-3 algorithm in patients with end-stage renal disease for cardiovascular risk stratification and to develop a mathematical model for predicting kidney transplant outcomes including QRISK-3 score. Material and methods. We examined 191 patients before and after kidney transplantation. Patients were divided into 3 groups depending on the outcomes after transplantation: group 1 with favorable outcomes — 157 (82.2%) patients, group 2 with graft loss — 30 (15.7%) patients, group 3 with fatal outcomes — 4 (2.1%) patients. Cardiovascular risks were calculated in all groups using the QRISK-3 algorithm. Prognostic value of this scale was assessed considering postoperative cardiovascular events. A mathematical model for predicting the kidney transplant outcomes was developed. Results. We found significant differences between groups 1 and 2, as well as 1 and 3 (p1—2<0.001, p1—3=0.002) in cardiovascular risk based on QRISK-3 score. There was a moderate correlation between QRISK-3 results and kidney transplant outcomes (R=0.439, p=0.000*). The model for predicting adverse cardiovascular events based on QRISK-3 score had high sensitivity (98.1%) and specificity (79.4%). When we developed a mathematical model for predicting kidney transplant outcomes, the QRISK-3 parameters were among three most important predictors. The model had high diagnostic value. Conclusion. The QRISK-3 prognostic algorithm is a valuable and easily reproducible tool not only in assessing cardiovascular risk among kidney transplant candidates and kidney recipients, but also in predicting transplant outcomes.