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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2023

Kód důvěrnosti údajů

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

Název periodika

Journal of the American Society of Nephrology

ISSN

1046-6673

e-ISSN

1533-3450

Svazek periodika

34

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

505-514

Kód UT WoS článku

000943504200016

EID výsledku v databázi Scopus

2-s2.0-85149173900