RT Journal Article
SR Electronic
T1 Validation of the ANCA Renal Risk Score and Modification of the Score in a majority-owned MPO positive Chinese cohort
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.220818
DO 10.3899/jrheum.220818
A1 Anqi Ni
A1 Liangliang Chen
A1 Lan Lan
A1 Yaomin Wang
A1 Pingping Ren
A1 Yilin Zhu
A1 Ying Xu
A1 Xiaoqi Shen
A1 Qin Zhou
A1 Xiaohan Huang
A1 Huiping Wang
A1 Jianghua Chen
A1 Fei Han
YR 2023
UL http://www.jrheum.org/content/early/2023/01/10/jrheum.220818.abstract
AB Objective We aimed to validate and modify the renal risk score for antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN) in a Chinese cohort with a majority of myeloperoxidase (MPO)-positive patients. Methods A total of 285 AAGN patients with biopsy-proven in our center were retrospectively included. Patients were randomly assigned to the development set (n=201) and the validation set (n=84). We calculated the renal risk score and analyzed the clinicopathological characteristics and follow-up data. The nomogram was constructed based on the independent prognostic factors identified by the multivariable Cox regression and then compared with the renal risk score. Results Over a median follow-up period of 41.3 (20.0-63.8) months, 84 (29.5%) patients reached endstage kidney disease (ESKD). In the development set, hypertension (HR=2.163, 95%CI 1.083-4.322, P=0.029), high serum creatinine (HR=1.002, 95%CI 1.001-1.003, P<0.001), high daily urine protein (HR=1.343, 95%CI 1.148-1.571, P<0.001), high glomerular sclerosis (HR=13.983, 95%CI 3.496-55.923, P<0.001), and interstitial fibrosis>50% (HR=4.179, 95%CI 1.900-9.192, P<0.001) were independent risk factors for ESKD, and these indicators were included in the nomogram. The C-indices of the nomogram model in the development set, validation set, and all-data set were 0.838 (0.785-0.891), 0.794 (0.774- 0.814), and 0.822 (0.775-0.869), respectively, which were higher than those of the renal risk score model, 0.801 (0.748-0.854), 0.746 (0.654-0.838) and 0.783 (0.736-0.830), respectively. And the net reclassification improvement and the integrated discrimination improvement further illustrated the higher predictive ability of the nomogram. Conclusion We present a nomogram as a practical tool to predict renal outcomes in Chinese patients with an MPO-ANCA glomerulonephritis.