A Validation Study Comparing Risk Prediction Models of IgA Nephropathy.

A Validation Study Comparing Risk Prediction Models of IgA Nephropathy.
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比较 IgA 肾病风险预测模型的验证研究

DOI:
10.3389/fimmu.2021.753901
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发表时间:
2021
影响因子:
7.3
通讯作者:
Chen N
Chen N
中科院分区:
医学2区
文献类型:
--
作者:
Ouyang Y;Zhao Z;Li G;Luo H;Xu F;Shao L;Chen Z;Yu S;Jin Y;Xu J;Shi M;Hussain HMJ;Du W;Fang Z;Pan X;Wang W;Xie J;Chen N

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我们的目的是验证国际合作研究提出的三个IgAN风险模型和我们的多中心中国IgAN队列扩展CKD队列生成的另一个CKD风险模型。入组了基线时eGFR ≥15 ml/min/1.73 m2且至少随访6个月的活检证实的IgAN患者。主要结局为复合结局(eGFR或ESRD下降50%)和ESRD。这些模型的性能进行了评估,使用歧视,校准和重新分类。共有2,300例合格病例入组。其中,288例(12.5%)患者达到复合结局,214例(9.3%)患者在中位随访期30个月内达到ESRD。使用复合结局进行分析,临床、有限、完全和CKD模型具有相对较好的性能,具有相似的C统计量(分别为0.81、0.81、0.82和0.82)。以ESRD为终点时,四种预测模型的性能更好(所有C统计量> 0.9)。此外,亚组分析显示,在基线eGFR较高(≥60 ml/min/1.73 m2)的低风险患者中,包含临床和病理变量的模型(全模型和有限模型)比仅包含临床指标的模型(临床模型和CKD模型)具有更好的区分能力。总之,我们在中国IgAN队列中验证了最近报道的IgAN和CKD风险模型。与纯临床模型相比,在基线eGFR ≥60 ml/min/1.73 m2的低风险IgAN患者中,增加病理变量将提高预测ESRD的性能。
We aimed to validate three IgAN risk models proposed by an international collaborative study and another CKD risk model generated by an extended CKD cohort with our multicenter Chinese IgAN cohort. Biopsy-proven IgAN patients with an eGFR ≥15 ml/min/1.73 m2 at baseline and a minimum follow-up of 6 months were enrolled. The primary outcomes were a composite outcome (50% decline in eGFR or ESRD) and ESRD. The performance of those models was assessed using discrimination, calibration, and reclassification. A total of 2,300 eligible cases were enrolled. Of them, 288 (12.5%) patients reached composite outcome and 214 (9.3%) patients reached ESRD during a median follow-up period of 30 months. Using the composite outcome for analysis, the Clinical, Limited, Full, and CKD models had relatively good performance with similar C statistics (0.81, 0.81, 0.82, and 0.82, respectively). While using ESRD as the end point, the four prediction models had better performance (all C statistics > 0.9). Furthermore, subgroup analysis showed that the models containing clinical and pathological variables (Full model and Limited model) had better discriminatory abilities than the models including only clinical indicators (Clinical model and CKD model) in low-risk patients characterized by higher baseline eGFR (≥60 ml/min/1.73 m2). In conclusion, we validated recently reported IgAN and CKD risk models in our Chinese IgAN cohort. Compared to pure clinical models, adding pathological variables will increase performance in predicting ESRD in low-risk IgAN patients with baseline eGFR ≥60 ml/min/1.73 m2.
DOI: 10.1038/ncomms8270
发表时间: 2015-06-01
影响因子: 16.6
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发表时间: 2014
期刊: PloS one
影响因子: 3.7
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发表时间: 2016
期刊: PloS one
影响因子: 3.7
作者:
Ouyang Y;Xie J;Yang M;Zhang X;Ren H;Wang W;Chen N
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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:
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IgA肾病的新风险基因座的发现暗示了与肠道病原体免疫有关的基因。
DOI: 10.1038/ng.3118
发表时间: 2014-11
期刊: NATURE GENETICS
影响因子: 30.8
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