Berthoux et al reported a score for predicting poor outcome for a patient with IgA nephropathy. This can help to identify a patient who may require more aggressive management. The authors are from University North Hospital (Saint-Etienne), PRES Universite de Lyon and Universite Jean Monnet de Saint-Etienne in France.
Patient selection: IgA nephropathy
Outcomes: dialysis (end-stage renal disease) or death
Parameters:
(1) hypertension
(2) proteinuria in grams per day
(3) pathologic lesions in first renal biopsy, based on the global optical score (GOS) of Alamartine et al
Parameter
Finding
Points
hypertension
absent
0
present
1
proteinuria
< 1 gram per day
0
>= 1 gram per day
1
global optical score
< 8
0
>= 8 (severe)
1
where:
• The GOS is a sum of glomerular, tubular, interstitial, and vascular indices.
total score = absolute renal risk score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The prognosis can be improved by treating the hypertension and proteinuria if present.
Absolute Renal Risk (ARR) Score
10 Year Risk
20 Year Risk
0
2%
4%
1
2%
9%
2
7%
18%
3
29%
64%
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