Long-term risk of ESRD in IgAN; validation of Japanese prognostic model in a Norwegian cohort
Long-term risk of ESRD in IgAN; validation of Japanese prognostic model in a Norwegian cohort
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DOI：
10.1093/ndt/gfr446
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发表时间：
2012-04-01
影响因子：
6.1
通讯作者：
Iversen, Bjarne M.
中科院分区：
文献类型：
--
作者：
Bjorneklett, Rune;Vikse, Bjorn Egil;Iversen, Bjarne M.
背景最近，日本发表了一个用于预测伊加肾病（IgAN）患者终末期肾病（ESRD）10年风险的模型。我们在挪威IgAN患者队列中检测日本模型在预测10- 20年ESRD风险和全因死亡率方面的适用性。IgAN患者队列（1988-2004年）在挪威肾活检登记处（NKBR）中确定，通过与挪威肾登记处（ESRD）和挪威人口登记处（死亡）的记录联系，确定了2008年随访期间的ESRD或死亡。根据日本预后模型，来自NKBR的数据用于将患者分为9个不同的预后组（0-1，1-5，5-10，10-20，20-30，30-50，50-70，70-90和>90%的ESRD风险）。比较不同预后组中预测的ESRD风险与测量的ESRD风险。在9个风险组中的8个中，代表我们队列中597/633（94%）例患者，观察到的10年风险在ESRD预期10年风险范围内或接近ESRD预期10年风险。观察>10年后发生的ESRD在10年随访时预期风险为5-30%的组中最常见。ESRD风险与ESRD前死亡风险密切相关。日本预后模型适用于预测挪威IgAN患者的10年ESRD风险。本研究的一个新发现是，该模型还可用于预测哪些患者在10-20年随访后发生ESRD的风险最高，以及全因死亡风险。
Background. Recently, a Japanese model used to predict 10-year risk of end-stage renal disease (ESRD) in IgA nephropathy (IgAN) patients was published. We tested the applicability of the Japanese model in predicting 10- to 20-year risk of ESRD and all-cause mortality in a cohort of Norwegian IgAN patients.Methods. A cohort of IgAN patients (1988-2004) were identified in the Norwegian Kidney Biopsy Registry (NKBR) and ESRD or death during follow-up through 2008 was identified through record linkage with the Norwegian Renal Registry (ESRD) and the Norwegian Population Registry (deaths). Data from the NKBR were used to classify patients into nine different prognostic groups (0-1, 1-5, 5-10, 10-20, 20-30, 30-50, 50-70, 70-90 and >90% risk of ESRD) according to the Japanese prognostic model. The predicted risk was compared to the measured risk of ESRD in the different prognostic groups.Results. In eight of the nine risk groups, representing 597/633 (94%) of the patients in our cohort, the observed 10-year risk was within or close to the expected 10-year risk of ESRD. ESRD occurring after >10 years of observation was most frequent in the groups with 5-30% expected risk at 10 years of follow-up. A close association between risk of ESRD and risk of death prior to ESRD was observed.Conclusions. The Japanese prognostic model is applicable to predict 10-year risk of ESRD in Norwegian IgAN patients. A new finding in the present study is that the model can also be used to predict which patients have the highest risk of developing ESRD after 10-20 years of follow-up as well as all-cause mortality risk.