Objective: To validate the renal risk score in a cohort of patients with advanced kidney damage.
Methods: A total of 72 patients with biopsy-proven ANCA glomerulonephritis with >12 months of follow-up were studied. The renal risk score was calculated and evaluated by survival analysis for time of renal survival. Cohort-specific clinical, histopathologic, and post-treatment factors associated with renal survival were determined by Cox regression analysis.
Results: Kidney biopsies were classified as focal, crescentic, mixed, and sclerotic classes in 6 (8%), 4 (6%), 25 (35%), and 37 (51%) patients, respectively. The 1-, 3-, and 5-year renal survival rates were 79%, 73%, and 68%, respectively. Patients were segregated by the risk score in low- (18%), medium- (47%), and high-risk (35%) groups. Patients in the low-risk group had 36-, 60-, and 84-month renal survival of 100%; those in the medium risk 85% (95% CI 72-92), 81% (95% CI 66-95), and 76% (95% CI 60-92), respectively; and those in the high risk 37% (95% CI 17-57), 26% (95% CI 7-45), and 18% (95% CI 1-36), respectively. Six (43%) of the 14 patients in the high-risk group recovered renal function after the initial episode, and 2 (14%) remained dialysis-free. Other parameters associated with renal survival included age, proteinuria, general symptoms, cellular crescents, glomerulosclerosis, tubulointerstitial lesions, best post-treatment eGFR, and renal relapses.
Conclusions: We validated the renal risk score as a prognostic tool in a cohort with predominantly mixed and sclerotic histologic categories. Since patients in the high-risk group still benefited from immunosuppressive therapy, this score should be used in conjunction with other predictive parameters to aid therapeutic decisions.Key Points• The ANCA renal risk score is validated in a cohort with advanced kidney damage.• Patients in the high-risk group still benefited from immunosuppressive therapy.• Parameters not included in the risk score are associated with renal survival and may be useful.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s10067-020-04936-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Impact of Modifiable Risk Factors on the Endothelial Cell Methylome and Cardiovascular Disease Development.
Front Biosci (Landmark Ed)
January 2025
School of Cardiovascular and Metabolic Medicine & Sciences, British Heart Foundation Centre of Research Excellence, King's College London, SE5 9NU London, UK.
Cardiovascular disease (CVD) is the most prevalent cause of mortality and morbidity in the Western world. A common underlying hallmark of CVD is the plaque-associated arterial thickening, termed atherosclerosis. Although the molecular mechanisms underlying the aetiology of atherosclerosis remain unknown, it is clear that both its development and progression are associated with significant changes in the pattern of DNA methylation within the vascular cell wall.
View Article and Find Full Text PDFSelf-reported health status of patients with acute retinal ischemia and stroke related hemianopia.
Eur Stroke J
January 2025
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Background: We aimed to assess impairments on health-related quality of life, and mental health resulting from Retinal artery occlusion (RAO) with monocular visual field loss and posterior circulation ischemic stroke (PCIS) with full or partial hemianopia using patient-reported outcome measures (PROMs).
Methods: In a prospective study, consecutive patients with acute RAO on fundoscopy and PCIS on imaging were recruited during their surveillance on a stroke unit over a period of 15 months. Baseline characteristics were determined from medical records and interviews.
Association of Geriatric Nutritional Risk Index Scores with Outcomes in Patients Undergoing Maintenance Hemodialysis.
Br J Hosp Med (Lond)
January 2025
Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
The Geriatric Nutritional Risk Index (GNRI) is an effective tool for identifying malnutrition, and helps monitor the prognosis of patients undergoing maintenance hemodialysis. However, the association between the GNRI and cardiovascular or all-cause mortality in hemodialysis patients remains unclear. Therefore, this study investigated the correlation of the GNRI with all-cause and cardiovascular mortality in patients undergoing maintenance hemodialysis.
View Article and Find Full Text PDFHow Outcome Prediction Could Aid Clinical Practice.
Br J Hosp Med (Lond)
January 2025
Department of Surgery & Cancer, Imperial College London, London, UK.
Predictive algorithms have myriad potential clinical decision-making implications from prognostic counselling to improving clinical trial efficiency. Large observational (or "real world") cohorts are a common data source for the development and evaluation of such tools. There is significant optimism regarding the benefits and use cases for risk-based care, but there is a notable disparity between the volume of clinical prediction models published and implementation into healthcare systems that drive and realise patient benefit.
View Article and Find Full Text PDFDevelopment and Validation of a GULP-Based Predictive Model for Dehydration in Elderly Patients with Post-Stroke Dysphagia.
Br J Hosp Med (Lond)
January 2025
Speech and Language Rehabilitation Department, Beijing Rehabilitation Hospital Affiliated with Capital Medical University, Beijing, China.
The background for establishing and verifying a dehydration prediction model for elderly patients with post-stroke dysphagia (PSD) based on General Utility for Latent Process (GULP) is as follows: For elderly patients with PSD, GULP technology is utilized to build a dehydration prediction model. This aims to improve the accuracy of dehydration risk assessment and provide clinical intervention, thereby offering a scientific basis and enhancing patient prognosis. This research highlights the innovative application of GULP technology in constructing complex medical prediction models and addresses the special health needs of elderly stroke patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!