Barbour et al reported a model for predicting outcome for a patient with IgA nephropathy. This can help to identify a patient who may benefit from more aggressive management. The authors are from the International Nephrology Network.
The authors are from multiple institutions from around the world.
Patient selection: IgA nephropathy
Outcome: 50% decline in eGFR or end-stage renal disease (ESRD) at 5-years after biopsy
Parameters at time of biopsy:
(1) eGFR in mL per min per 1.73 square meters
(2) mean arterial pressure in mm Hg
(3) proteinuria in grams per day
(4) histology by MEST score (Oxford classification)
(5) age in years
(6) race
(7) renin-angiotensin system blocker therapy (RASB, ACEI or ARB)
(8) immunosuppression
Parameter
Finding
Points
eGFR
-0.351 * ((SQRT(eGFR)) - 8.8)
mean arterial pressure
-0.0002 * ((MAP)-97)
proteinuria
-0.093 * ((LN(protein))-0.09)
histology
M0
0
M1
0.155
E0
0
E1
-0.131
S0
0
S1
0.097
T0
0
T1
0.607
T2
1.189
age
-0.016 * ((age)-38)
race
Chinese
0.818
Japanese
0.408
other
-0.431
White
0
RASB
no
0
yes
0.246
immunosuppression
no
0
yes
-0.225
Composite Parameters
Points
MAP and proteinuria
0.006 * ((MAP*LN(proteinuria)) - 8.73)
T1 and proteinuria
0.109 * (T1) * LN(proteinuria)
T2 and proteinuria
-0.339 * (T2) * LN(proteinuria)
X =
= SUM(points for all of the parameters)
probability of decline in eGFR or ESRD at 5 years =
= 0.95494^EXP(X)
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