Vasculitis & polymyalgia rheumatica
Validation of the Antineutrophil Cytoplasmic Antibody Renal Risk Score and Modification of the Score in a Chinese Cohort With a Majority of Myeloperoxidase-Positive Patients
Authors' conclusion
We present a nomogram as a practical tool to predict renal outcomes in Chinese patients with MPO-ANCA glomerulonephritis.
Study context
- Population
- Patients with biopsy-proven antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis, Chinese cohort with a majority MPO-positive, single centredevelopment 201, validation 84
- Participants
- 285 patients
- Exposure
- Nomogram vs renal risk score for predicting end-stage kidney disease (ESKD)
- Outcome
- ESKD
Methodological detailssingle-centre, prognostic model development and validation, multivariable Cox regression, nomogram
- Single-centre
- Prognostic model development and validation
- Multivariable Cox regression
- Nomogram
Main finding
As reported in the abstract
Discrimination for ESKD (C-index)
| Group | C-index, development set | C-index, validation set | C-index, all-data set |
|---|---|---|---|
| Nomogram | 0.838 (range 0.785-0.891) | 0.794 (range 0.774-0.814) | 0.822 (range 0.775-0.869) |
| Renal risk score | 0.801 (range 0.748-0.854) | 0.746 (range 0.654-0.838) | 0.783 (range 0.736-0.830) |
C-index, development set
Nomogram0.838 (range 0.785-0.891)
Renal risk score0.801 (range 0.748-0.854)
C-index, validation set
Nomogram0.794 (range 0.774-0.814)
Renal risk score0.746 (range 0.654-0.838)
C-index, all-data set
Nomogram0.822 (range 0.775-0.869)
Renal risk score0.783 (range 0.736-0.830)
Observational data: associations, not effects.
Further findings
Independent risk factors for ESKD (development set)
| HR (95% CI) | P value | ||
|---|---|---|---|
| Hypertension | 2.16 (1.08–4.32) | P = 0.03 | |
| High serum creatinine | 1.002 (1.001–1.003) | P < 0.001 | |
| High daily urine protein | 1.34 (1.15–1.57) | P < 0.001 | |
| High glomerular sclerosis | 13.98 (3.50–55.92) | P < 0.001 | |
| Interstitial fibrosis > 50% | 4.18 (1.90–9.19) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
ESKD over follow-up (all patients) · median 41.3 (range 20.0-63.8) months
- Patients reaching ESKD
- 84 (29.5%)
Original publication
Validation of the Antineutrophil Cytoplasmic Antibody Renal Risk Score and Modification of the Score in a Chinese Cohort With a Majority of Myeloperoxidase-Positive Patients. J Rheumatol. Published 15 January 2023. doi:10.
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