Development and validation of a novel score to predict dialysis inadequacy in continuous ambulatory peritoneal dialysis patients

Objective Adequate dialysis is of great importance for continuous ambulatory peritoneal dialysis (CAPD) patients. This study aimed to develop and validate an easily applicable quantitative dialysis adequacy risk scoring system in CAPD patients based on laboratory parameters from a single blood draw. Methods A total of 634 CAPD patients from four study centers were enrolled in this study (345 and 289 patients in development and validation groups, respectively). A risk score model for inadequate dialysis was developed based on multivariate regression analysis, which was validated by the area under the receiver operator curve and calibrated by a calibration curve. Results Seven independent predictors for inadequate dialysis were identified in the development group (male sex, hypoalbuminemia, anemia, being overweight, hyperuricemia, estimated glomerular filtration rate <4.7 mL/min/1.73 m(2), and serum creatinine >800 mu mol/L). A risk prediction score model was established and validated in the development and validation groups. Further analysis indicated that this model is suitable for CAPD patients with a wide range of clinical manifestations. Conclusion An easily applicable novel risk scoring system was established to detect inadequate dialysis in CAPD patients.