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Risk stratification to predict renal survival in anti-glomerular basement membrane disease

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F23%3A00083797" target="_blank" >RIV/00023001:_____/23:00083797 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11110/23:10458408 RIV/00064165:_____/23:10458408

  • Result on the web

    <a href="https://journals.lww.com/jasn/Fulltext/2023/03000/Risk_Stratification_to_Predict_Renal_Survival_in.16.aspx" target="_blank" >https://journals.lww.com/jasn/Fulltext/2023/03000/Risk_Stratification_to_Predict_Renal_Survival_in.16.aspx</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1681/ASN.2022050581" target="_blank" >10.1681/ASN.2022050581</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Risk stratification to predict renal survival in anti-glomerular basement membrane disease

  • Original language description

    Background Prospective randomized trials investigating treatments and outcomes in anti-glomerular basement membrane (anti-GBM) disease are sparse, and validated tools to aid prognostication or management are lacking.Methods In a retrospective, multicenter, international cohort study, we investigated clinical and histologic parameters predicting kidney outcome and sought to identify patients who benefit from rescue immunosuppressive therapy. We also explored applying the concept of the renal risk score (RRS), currently used to predict renal outcomes in ANCA-associated vasculitis, to anti-GBM disease.Results The final analysis included 174 patients (out of a total of 191). Using Cox and Kaplan-Meier methods, we found that the RRS was a strong predictor for ESKD. The 36-month renal survival was 100%, 62.4%, and 20.7% in the low-risk, moderate-risk, and high-risk groups, respectively. The need for renal replacement therapy (RRT) at diagnosis and the percentage of normal glomeruli in the biopsy were independent predictors of ESKD. The best predictor for renal recovery was the percentage of normal glomeruli, with a cut point of 10% normal glomeruli providing good stratification. A model with the predictors RRT and normal glomeruli (N) achieved superior discrimination for significant differences in renal survival. Dividing patients into four risk groups led to a 36-month renal survival of 96.4% (no RRT, N &gt;= 10%), 74.0% (no RRT, N &lt; 10%), 42.3% (RRT, N &gt;= 10%), and 14.1% (RRT, N &lt; 10%), respectively. Conclusions These findings demonstrate that the RRS concept is transferrable to anti-GBM disease. Stratifying patients according to the need for RRT at diagnosis and renal histology improves prediction, highlighting the importance of normal glomeruli. Such stratification may assist in the management of anti-GBM disease.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30217 - Urology and nephrology

Result continuities

  • Project

  • Continuities

    N - Vyzkumna aktivita podporovana z neverejnych zdroju

Others

  • Publication year

    2023

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Journal of the American Society of Nephrology

  • ISSN

    1046-6673

  • e-ISSN

    1533-3450

  • Volume of the periodical

    34

  • Issue of the periodical within the volume

    3

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    10

  • Pages from-to

    505-514

  • UT code for WoS article

    000943504200016

  • EID of the result in the Scopus database

    2-s2.0-85149173900