Develop and Validate a Risk Score in Predicting Renal Failure in Focal Segmental Glomerulosclerosis

Introduction The aim of this study is to develop and validate a risk score for end stage kidney disease (ESKD) in patients with focal segmental glomerulosclerosis (FSGS). Methods Patient with biopsy proven FSGS were enrolled. All the patients were allocated 1:1 to the two groups according to their b...

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Main Authors: Yikai Cai (Author), Yunzi Liu (Author), Jun Tong (Author), Yuanmeng Jin (Author), Jian Liu (Author), Xu Hao (Author), Yinhong Ji (Author), Jun Ma (Author), Xiaoxia Pan (Author), Nan Chen (Author), Hong Ren (Author), Jingyuan Xie (Author)
Format: Book
Published: Karger Publishers, 2023-03-01T00:00:00Z.
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Summary:Introduction The aim of this study is to develop and validate a risk score for end stage kidney disease (ESKD) in patients with focal segmental glomerulosclerosis (FSGS). Methods Patient with biopsy proven FSGS were enrolled. All the patients were allocated 1:1 to the two groups according to their baseline gender, age and baseline creatinine level by using a stratified randomization method. ESKD was the primary endpoint. Results We recruited 359 FSGS patients,177 subjects were assigned to group 1 and 182 to group 2. The clinicopathological variables were similar between two groups. There were 23 (13%) subjects reached to ESKD in group 1 and 22 (12.1%) in group 2. By multivariate Cox regression analyses we established risk scores (RS) 1 and RS 2 in groups 1 and 2, respectively. RS1 consists of five parameters including lower eGFR, higher urine protein, MAP, IgG level, and tubular-interstitial lesion (TIL) score; RS2 also consists of five predictors including lower C3, higher MAP, IgG level, hemoglobin and TIL score. RS1 and RS2 were cross-validated between these two groups, showing RS1 had better performance in predicting 5-year ESKD in Group1 [c statics, 0.86(0.74-0.98) vs 0.82(0.69-0.95] and Group2 [c statics, 0.91(0.83-0.99) vs 0.89(0.79-0.99)] compared to RS2. We then stratified the risk factors into four groups and Kaplan-Meier survival curve revealed that patients progressed to ESKD increased as risk levels increased. Conclusions A predictive model incorporated clinicopathological features was developed and validated for the prediction of ESKD in FSGS patients.
Item Description:2296-9381
2296-9357
10.1159/000529773