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 >= 10%), 74.0% (no RRT, N < 10%), 42.3% (RRT, N >= 10%), and 14.1% (RRT, N < 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
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30217 - Urology and nephrology
Result continuities
Project
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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