Predicting progression of IgA nephropathy: new clinical progression risk score.
Predicting progression of IgA nephropathy: new clinical progression risk score.
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预测 IgA 肾病的进展：新的临床进展风险评分
DOI：
10.1371/journal.pone.0038904
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Chen N
中科院分区：
文献类型：
--
作者：
Xie J;Kiryluk K;Wang W;Wang Z;Guo S;Shen P;Ren H;Pan X;Chen X;Zhang W;Li X;Shi H;Li Y;Gharavi AG;Chen N
伊加肾病（IgAN）是亚洲终末期肾病（ESRD）的常见原因。在这项研究中，基于中国IgAN患者的大型队列，我们的目的是确定与疾病进展为ESRD相关的独立预测因素。我们收集了619例活检诊断的IgAN患者的回顾性临床数据和肾脏结局，平均随访时间为41.3个月。总共有67名患者达到了研究终点，定义为发生需要肾脏替代治疗的ESRD。在完全校正的考克斯比例风险模型中，有四个基线变量对ESRD风险具有显著的独立影响。这些包括：eGFR [HR = 0.96（0.95-0.97）]、血清白蛋白[HR = 0.47（0.32-0.68）]、血红蛋白[HR = 0.79（0.72-0.88）]和SBP [HR = 1.02（1.00-1.03）]。 基于这些观察，我们开发了一个疾病进展的临床风险评分的4变量方程。我们的风险评分解释了主要结局总方差的近22%。生存ROC曲线显示，与之前提出的三种风险评分相比，风险评分在第24、60和120个月随访时提供了更好的ESRD预测。总之，我们的数据表明，基线时收缩压较高、eGFR、血红蛋白和白蛋白水平较低的IgAN患者进展为ESRD的风险最大。基于这四个基线变量计算的新进展风险评分为风险分层提供了一个简单的临床工具。
IgA nephropathy (IgAN) is a common cause of end-stage renal disease (ESRD) in Asia. In this study, based on a large cohort of Chinese patients with IgAN, we aim to identify independent predictive factors associated with disease progression to ESRD. We collected retrospective clinical data and renal outcomes on 619 biopsy-diagnosed IgAN patients with a mean follow-up time of 41.3 months. In total, 67 individuals reached the study endpoint defined by occurrence of ESRD necessitating renal replacement therapy. In the fully adjusted Cox proportional hazards model, there were four baseline variables with a significant independent effect on the risk of ESRD. These included: eGFR [HR = 0.96(0.95–0.97)], serum albumin [HR = 0.47(0.32–0.68)], hemoglobin [HR = 0.79(0.72–0.88)], and SBP [HR = 1.02(1.00–1.03)]. Based on these observations, we developed a 4-variable equation of a clinical risk score for disease progression. Our risk score explained nearly 22% of the total variance in the primary outcome. Survival ROC curves revealed that the risk score provided improved prediction of ESRD at 24th, 60th and 120th month of follow-up compared to the three previously proposed risk scores. In summary, our data indicate that IgAN patients with higher systolic blood pressure, lower eGFR, hemoglobin, and albumin levels at baseline are at a greatest risk of progression to ESRD. The new progression risk score calculated based on these four baseline variables offers a simple clinical tool for risk stratification.
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DOI：
10.1093/ndt/gfp273
发表时间：
2009-10
期刊：
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
影响因子：
--
作者：
Goto M;Wakai K;Kawamura T;Ando M;Endoh M;Tomino Y
通讯作者：
Tomino Y
影响因子：
13.2
作者：
Bartosik, LP;Lajoie, G;Cattran, DC
通讯作者：
Cattran, DC
影响因子：
--
作者：
Mackinnon, Bruce;Fraser, Emily P.;Geddes, Colin C.
通讯作者：
Geddes, Colin C.
影响因子：
6.1
作者：
Li, PKT;Ho, KKL;Lai, FMM
通讯作者：
Lai, FMM
影响因子：
2.5
作者：
Lv, Jicheng;Zhang, Hong;Wang, Haiyan
通讯作者：
Wang, Haiyan