Irish et al20 recently described risk factors for DGF
from a large registry data set (Box 1). Although this
registry was unable to capture specifics of patient
management and organ preservation, the analysis unveiled
the most important epidemiologic associations
as cold ischemic time, use of DCD kidneys, donor
age, donor body mass index, and donor creatinine
level. The authors noted that with time, the importance
of donor kidney function has increased, whereas
that of immunologic risk factors has lessened, the
latter possibly related to enhanced immunosuppression
protocols in current use. The authors subsequently
proceeded to develop a mathematical nomogram
to predict the risk of DGF, although
discrimination afforded by this model was moderate
(C statistic 0.70) and calls into question whether
this (or any other) nomogram is of true predictive
utility.