The improved kidney risk score in ANCA-associated vasculitis for clinical practice and trials

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00084587" target="_blank" >RIV/00023001:_____/24:00084587 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/24:10475717 RIV/00064165:_____/24:10475717

Výsledek na webu

<a href="https://journals.lww.com/jasn/abstract/2024/03000/the_improved_kidney_risk_score_in_anca_associated.9.aspx" target="_blank" >https://journals.lww.com/jasn/abstract/2024/03000/the_improved_kidney_risk_score_in_anca_associated.9.aspx</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1681/ASN.0000000000000274" target="_blank" >10.1681/ASN.0000000000000274</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The improved kidney risk score in ANCA-associated vasculitis for clinical practice and trials

Popis výsledku v původním jazyce

Background Reliable prediction tools are needed to personalize treatment in ANCA-associated GN. A retrospective international longitudinal cohort was collated to revise the ANCA renal risk score. Methods The primary end point was ESKD with patients censored at last follow-up. Cox proportional hazards were used to reweight risk factors. Kaplan-Meier curves, Harrell&apos;s C statistic, receiver operating characteristics, and calibration plots were used to assess model performance. Results Of 1591 patients, 1439 were included in the final analyses, 2:1 randomly allocated per center to development and validation cohorts (52% male, median age 64 years). In the development cohort (n=959), the ANCA renal risk score was validated and calibrated, and parameters were reinvestigated modifying interstitial fibrosis and tubular atrophy allowing semiquantitative reporting. An additional cutoff for kidney function (K) was identified, and serum creatinine replaced GFR (K0: &lt;250 mmol/L=0, K1: 250-450 mmol/L=4, K2: &gt;450 mmol/L=11 points). The risk points for the percentage of normal glomeruli (N) and interstitial fibrosis and tubular atrophy (T) were reweighted (N0: &gt;25%=0, N1: 10%-25%=4, N2: &lt;10%=7, T0: none/mild or &lt;25%=0, T1: &gt;= mild-moderate or &gt;= 25%=3 points), and four risk groups created: low (0-4 points), moderate (5-11), high (12-18), and very high (21). Discrimination was C=0.831, and the 3-year kidney survival was 96%, 79%, 54%, and 19%, respectively. The revised score performed similarly well in the validation cohort with excellent calibration and discrimination (n=480, C=0.821). Conclusions The updated score optimizes clinicopathologic prognostication for clinical practice and trials.

Název v anglickém jazyce

The improved kidney risk score in ANCA-associated vasculitis for clinical practice and trials

Popis výsledku anglicky

Background Reliable prediction tools are needed to personalize treatment in ANCA-associated GN. A retrospective international longitudinal cohort was collated to revise the ANCA renal risk score. Methods The primary end point was ESKD with patients censored at last follow-up. Cox proportional hazards were used to reweight risk factors. Kaplan-Meier curves, Harrell&apos;s C statistic, receiver operating characteristics, and calibration plots were used to assess model performance. Results Of 1591 patients, 1439 were included in the final analyses, 2:1 randomly allocated per center to development and validation cohorts (52% male, median age 64 years). In the development cohort (n=959), the ANCA renal risk score was validated and calibrated, and parameters were reinvestigated modifying interstitial fibrosis and tubular atrophy allowing semiquantitative reporting. An additional cutoff for kidney function (K) was identified, and serum creatinine replaced GFR (K0: &lt;250 mmol/L=0, K1: 250-450 mmol/L=4, K2: &gt;450 mmol/L=11 points). The risk points for the percentage of normal glomeruli (N) and interstitial fibrosis and tubular atrophy (T) were reweighted (N0: &gt;25%=0, N1: 10%-25%=4, N2: &lt;10%=7, T0: none/mild or &lt;25%=0, T1: &gt;= mild-moderate or &gt;= 25%=3 points), and four risk groups created: low (0-4 points), moderate (5-11), high (12-18), and very high (21). Discrimination was C=0.831, and the 3-year kidney survival was 96%, 79%, 54%, and 19%, respectively. The revised score performed similarly well in the validation cohort with excellent calibration and discrimination (n=480, C=0.821). Conclusions The updated score optimizes clinicopathologic prognostication for clinical practice and trials.

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

2024

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

35

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

12

Strana od-do

335-346

Kód UT WoS článku

001151732000001

EID výsledku v databázi Scopus

2-s2.0-85186319182