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

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 VecciaMaria 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

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Objective: To externally validate Yonsei nomogram. Methods: 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. Results and limitation: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)308-317
Number of pages10
JournalInternational Journal of Urology
Issue number3
Publication statusPublished - 2023 Mar

Bibliographical note

Publisher Copyright:
© 2022 The Japanese Urological Association.

All Science Journal Classification (ASJC) codes

  • Urology


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