Abstract:
Background. Chronic kidney disease (CKD) is an established risk factor for cardiovascular
disease (CVD), yet traditional risk prediction models often underestimate the true risk in
this population. QRISK-3, a contemporary CVD risk calculator developed in the UK,
incorporates CKD as a specific variable.
Objective(s). To evaluate the applicability, strengths, and limitations of the QRISK-3 tool in
stratifying cardiovascular risk among patients with CKD in various stages of evolution and
in hemodialysis patients.
Materials and methods. The study included 200 patients with chronic kidney disease in
KDIGO stage IV–V, from IMSP SCM "Sfânta Treime", in the period 2022–2023, assessed
according to the QRISK-3 criteria. An analysis of the current evidence regarding the QRISK3 components, validation studies in CKD populations and comparison with alternative risk
scores was performed.
Results. Predictor variables were examined based on established risk factors and patients
were classified as having an increased risk of cardiovascular disease if their 10-year risk was
10% or higher. Using the QRISK-3 tool, the number of patients included in the study with a
10-year risk score of 15% or higher was 84.5%, which denotes the major impact of
cardiovascular complications in this vulnerable category of patients. QRISK-3 considerably
improves risk estimation in CKD compared to previous models (e.g., Framingham, SCORE)
but remains very limited in patients on dialysis or with advanced CKD (eGFR <30
mL/min/1.73 m²).
Conclusion(s). Although the QRISK-3 score is a very useful tool for cardiovascular risk
stratification in early-stage chronic kidney disease, further rigorous refinements and
external validation are needed for practical application for patients with advanced CKD and
dialysis patients.
