Glomerular Diseases

Canetta, Pietro A.; Kiryluk, Krzysztof; Appel, Gerald B.

doi:10.2215/cjn.07260713

Cited by 31 publications

(32 citation statements)

References 57 publications

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“…Our findings are not surprising given the facts that proteinuria, hypertension, initial eGFR, and histopathological lesions are the four best documented traditional risk markers for progression to ESRD [4,5,6,17] and death in IgAN patients [21]. In principle, all prognostic models should be tested on populations that are independent of the cohort used to develop the models [16].…”

Section: Discussionmentioning

confidence: 99%

“…The clinical outcome of IgAN is variable, ranging from minor and stable asymptomatic disease to progressive renal failure and end-stage renal disease (ESRD) [4,5,6]. Identification of single risk factors in IgAN patients is valuable and has received considerable attention [7,8,9,10,11,12,13]; however, a combination of different risk factors is potentially even more useful, and a few models incorporating multiple factors have been published in recent years [4,5,6,14,15]. A reliable and widely generally accepted prognostic model can aid the nephrologist when informing the patient about the expected prognosis and deciding on follow-up and treatment regimens.…”

Section: Introductionmentioning

confidence: 99%

“…This model is simple to use, and the primary endpoint of ESRD or death is highly clinically significant. Of note, a well-established risk factor in IgAN patients, initial estimated glomerular filtration rate (eGFR) [4,5,6,17], is not included in this model. Neither is age, which is a very strong predictor for death and generally patients with chronic kidney disease (CKD) stage 3-5 consist of older patients than patients with CKD stage 1 or 2 [15,20].…”

Section: Introductionmentioning

confidence: 99%

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Addition of eGFR and Age Improves the Prognostic Absolute Renal Risk-Model in 1,134 Norwegian Patients with IgA Nephropathy

et al. 2015

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Background: Predicting outcome in individual patients with IgA nephropathy (IgAN) is difficult but important. For this purpose, the absolute renal risk (ARR) model has been developed in a French cohort to calculate the risk of end-stage renal disease (ESRD) and death. ARR (0-3) is scored in individual IgAN patients based on the presence of proteinuria ≥1 g/24 h, hypertension, and severe histopathological lesions (1 point per risk factor). We have validated the ARR model in a Norwegian cohort of IgAN patients and tested whether adding data on initial estimated glomerular filtration rate (eGFR) and age improved prediction. Methods: IgAN patients diagnosed between 1988 and 2012 were identified in the Norwegian Kidney Biopsy Registry, and endpoints were identified by record linkage with the Norwegian Renal Registry (ESRD) and the Population Registry (deaths). Results: We identified 1,134 IgAN patients. The mean duration of follow-up was 10.2 years (range 0.0 to 25.7 years). Two hundred and fifty one patients developed ESRD and there were 69 pre-ESRD deaths. The ARR model significantly stratified the IgAN cohort according to risk of ESRD/death. The inclusion of eGFR and age significantly improved the ARR prognostic model; in the receiver operator characteristics (ROC) analysis, area under the curve (AUC) at 10-years of follow-up increased from 0.79 to 0.89, p < 0.001. Conclusions: ARR is a suitable prognostic model for stratifying IgAN patients according to the risk of ESRD or death. Including initial eGFR and age in the model substantially improved its accuracy in our nationwide cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Addition of eGFR and Age Improves the Prognostic Absolute Renal Risk-Model in 1,134 Norwegian Patients with IgA Nephropathy

et al. 2015

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“…The clinical outcome of this disease ranges from asymptomatic hematuria to progressive renal failure and even end-stage renal disease (ESRD) [3][4][5]. Approximately 20-40% of affected patients will reach ESRD within 10-20 years of diagnosis [6,7].…”

Section: Introductionmentioning

confidence: 99%

Prediction of ESRD in IgA Nephropathy Patients from an Asian Cohort: A Random Forest Model

Liu

Zhang

Liu

et al. 2018

Kidney Blood Press Res

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Background/Aims: There is an increasing risk of end-stage renal disease (ESRD) among Asian people with immunoglobulin A nephropathy (IgAN). A computer-aided system for ESRD prediction in Asian IgAN patients has not been well studied. Methods: We retrospectively reviewed biopsy-proven IgAN patients treated at the Department of Nephrology of the Second Xiangya Hospital from January 2009 to November 2013. Demographic and clinicopathological data were obtained within 1 month of renal biopsy. A random forest (RF) model was employed to predict the ESRD status in IgAN patients. All cases were initially trained and validated, taking advantage of the out-of-bagging(OOB) error. Predictors used in the model were selected according to the Gini impurity index in the RF model and verified by logistic regression analysis. The area under the receiver operating characteristic(ROC) curve (AUC) and F-measure were used to evaluate the RF model. Results: A total of 262 IgAN patients were enrolled in this study with a median follow-up time of 4.66 years. The importance rankings of predictors of ESRD in the RF model were first obtained, indicating some of the most important predictors. Logistic regression also showed that these factors were statistically associated with ESRD status. We first trained an initial RF model using gender, age, hypertension, serum creatinine, 24-hour proteinuria and histological grading suggested by the Clinical Decision Support System for IgAN (CDSS, www.IgAN.net). This 6-predictor model achieved a F-measure of 0.8 and an AUC of 92.57%. By adding Oxford-MEST scores, this model outperformed the initial model with an improved AUC (96.1%) and F-measure (0.823). When C3 staining was incorporated, the AUC was 97.29% and F-measure increased to 0.83. Adding the estimated glomerular filtration rate (eGFR) improved the AUC to 95.45%. We also observed improved performance of the model with additional inputs of blood urea nitrogen (BUN), uric acid, hemoglobin and albumin. Conclusion: In addition to the predictors in the CDSS, Oxford-MEST scores, C3 staining and eGFR conveyed additional information for ESRD prediction in Chinese IgAN patients using a RF model.

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“…Moreover, IgAN is found in 40% of renal biopsy specimens obtained from primary glomerulonephritis (GN) patients in China and Japan, and the number is 30% in Europe and 20% in the United States (Canetta et al 2014). IgAN consists of primary IgAN and secondary IgAN, which is related to various diseases, including infections, immunological disorders and cancers (Khositseth et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Zhao

Sun

et al. 2017

Tohoku J. Exp. Med.

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IgA nephropathy (IgAN) is the most common cause of primary renal diseases worldwide, and the early secreted antigenic target of 6 (ESAT-6) which was secreted by Mycobacterium tuberculosis (MTB) may be involved in the development and progression of IgAN. This study aimed to investigate the role of ESAT-6 for early diagnosis of IgAN caused by MTB infection. From 2011 to 2014, 21 patients with renal tuberculosis (RTB), 25 with IgAN, and 46 with IgAN infected with MTB (IgAN/MTB) were enrolled. Serum levels of antibodies against Mycobacterium tuberculosis antigen 85A (Ag85A) were measured by ELISA. Urine culture and phage amplified biologically assay were performed to detect MTB. HE staining was used to observe the morphological changes in kidney tissues. Immunohistochemistry was applied to detect the expression of ESAT-6. Immunofluorescence staining was conducted to detect IgA1. Positive rates of serum anti-Ag85A antibody and urine culture for MTB were higher in the RTB and IgAN/MTB groups than those in the IgAN group. The positive rates of plaques were also higher in RTB and IgAN/MTB groups than the positive rate in the IgAN group. By contrast, the positive rate of ESAT-6 was lower in the IgAN group than that in the RTB group or the IgAN/MTB group, whereas the expression levels of IgA1 were higher in the IgAN and IgAN/MTB groups, compared with the RTB group. Our findings suggest that ESAT-6 and IgA1 may be helpful for early diagnosis of IgAN caused by MTB infection.

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Glomerular Diseases

Cited by 31 publications

References 57 publications

Addition of eGFR and Age Improves the Prognostic Absolute Renal Risk-Model in 1,134 Norwegian Patients with IgA Nephropathy

Addition of eGFR and Age Improves the Prognostic Absolute Renal Risk-Model in 1,134 Norwegian Patients with IgA Nephropathy

Prediction of ESRD in IgA Nephropathy Patients from an Asian Cohort: A Random Forest Model

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

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