Systematic Review and Meta-Analysis of ICU Scoring Systems Performance in Patients with Pre-Existing Kidney Disease

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Key Points

This review aims to assess how well ICU scoring systems predict mortality in patients with different stages of kidney disease.
Systematic review and meta-analysis of observational studies identified through Ovid Medline, Embase, and Scopus up to October 10, 2024.
Inclusion of 12 studies with 578,027 patients focusing on ICU scoring systems performance in chronic kidney disease, end-stage kidney disease, and kidney transplant recipients.
Comparison of performance metrics like AUROC and calibration between scoring systems and general ICU populations.
For end-stage kidney disease on dialysis, ICU scoring systems showed excellent AUROC but lower discrimination compared to the general ICU population.
Scoring systems consistently overestimated mortality risk in end-stage kidney disease patients.
Kidney transplant recipients showed poor discrimination in SAAPS III and SOFA scoring systems, with variable calibration.

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Systematic review evaluates ICU scoring systems' prognostic accuracy in kidney disease, indicating important disparities.

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El-wadia et al. (2026) studied this question.

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