Which index is optimal for assessment of baseline comorbidities in kidney transplant recipients?

Gabriel C Oniscu and John LR Forsythe*

This article has no abstract so we have provided the first paragraph of the full text.

Jassal et al. demonstrate for the first time that there is a correlation between various comorbidity indices and risk of mortality following renal transplantation. Their study investigated four scoring systems: the CCI, the Davies index, the Khan index and the modified CCI, all of which have been validated previously in patients with ESRD and confirmed as reproducible methods of recording the presence and severity of comorbidities. By using data from the Canadian Organ Replacement Registry, Jassal and colleagues show that an increased comorbidity index is associated with reduced patient survival after kidney transplantation. Of all the scoring systems investigated, the CCI appeared to provide the best correlation with survival. Nevertheless, the simple addition of individual disease indicators to a risk stratification model that included patient demographic characteristics, primary diagnosis and dialysis vintage provided an improvement in outcome prediction comparable to that achieved with the CCI. Not surprisingly, diabetes and cardiovascular disease were the most frequently encountered comorbid conditions.

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