Predicting risk of acute kidney injury in patients indicated for blood pressure lowering therapy
Acute kidney injury (AKI) is one of the more serious adverse events associated with antihypertensive treatment, reducing an individual’s health-related quality of life and increasing the risk of hospitalisation. Clinical guidelines recommend that when prescribing antihypertensives, physicians should take into account the likelihood of both the benefits and the harms from treatment.
The STRATIFY-AKI Risk Calculator allows physicians to better understand an individual’s likelihood of experiencing harm from acute kidney injury as a result of antihypertensive therapy. The calculator estimates an individual’s risk of hospitalisation or death from acute kidney injury in the next 1, 5 and 10 years. It is designed to be used in a primary care setting using information routinely available in a patient’s electronic health record. The calculator has been developed and validated in a nationally representative population with the following characteristics:
- Aged 40 years or older
- A systolic blood pressure reading between 130-179 mm Hg (indicating antihypertensive prescription maybe appropriate)
Details of the calculator development and external validation have been published in a peer-reviewed article and can be found here: Koshiaris et al. (2023) BJGP https://doi.org/10.3399/BJGP.2022.0389
Why is there no interactive calculator?
Many prediction models have accompanying interactive calculators published on websites (or as apps) for users to try out the algorithms and estimate risks for a given individual. However, UK medical device regulatory body, the Medicines and Healthcare products Regulatory Agency (MHRA), deems such calculators to be Class I medical devices (software as a medical device).
The STRATIFY-AKI Risk Calculator has not yet undergone the necessary process to attain this certification. Therefore at present, it can only be used for academic or scholarly use a piece of software, which can be freely downloaded from the Software Store.
The STRATIFY-AKI Calculator is freely available as software which allows you to implement the underlying algorithm in R Studio version 3.6.3 (or above) or STATA version 16.1 (or above). This software intended for academic or scholarly only and can be downloaded through the Software Store. If you are interested in a commercial licence, please contact firstname.lastname@example.org referencing project number 16875.
THE ALGORITHM INPUTS
The clinical codes used to define each of the predictors included in the algorithm are available on our dedicated Github page. We developed the algorithm using electronic health record data from the UK and so these codes are available in READ format.
The STRATIFY-AKI calculator may only be used or academic research and for the purpose of peer review.
For full terms and conditions please see the licence here.
PLEASE READ THESE LICENCE TERMS CAREFULLY BEFORE USING THE ALGORITHM. IF YOU DO NOT AGREE TO THESE LICENCE TERMS YOU MUST NOT ACCESS OR USE THE ALGORITHM.