Goto et al reported a score to predict renal outcome in a patient with IgA nephropathy. The authors are from Kyoto University, Nagoya University, Tokai University and Juntendo University in Japan.
Patient selection: IgA nephropathy
Parameters:
(1) sex
(2) age of the patient in years
(3) systolic blood pressure in mm Hg
(4) urine protein by dipstick
(5) number of RBCs per HPF in urinalysis
(6) serum albumin
(7) glomerular filtratrion rate in mL per min per 1.73 square meters
(8) histological Grade (Joint Commitee of the Research Group on Progressive Renal Disease)
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
6 |
|
age in years |
< 30 years |
12 |
|
|
>= 30 years |
0 |
|
systolic blood pressure |
<= 130 mm Hg |
0 |
|
|
131 to 160 mm Hg |
4 |
|
|
> 160 mm Hg |
11 |
|
urine protein |
negative or +/- |
0 |
|
|
1+ |
12 |
|
|
2+ |
21 |
|
|
3+ |
25 |
|
RBC per HPF |
0 |
0 |
|
|
1 to 29 (mild hematuria) |
8 |
|
|
>= 30 |
0 |
|
serum albumin |
< 4.0 g/dL |
7 |
|
|
>= 4.0 g/dL |
0 |
|
GFR |
>= 90 mL/min/1.73 sq m |
0 |
|
|
60 to 90 |
7 |
|
|
30 to 60 |
22 |
|
|
15 to 30 |
42 |
|
|
< 15 |
66 |
|
histologic grade |
0 to II |
0 |
|
|
III or IV |
5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 140
|
Total Score |
10-Year Risk ESRD |
|
<= 26 |
<= 1% |
|
27 to 43 |
1 to 5% |
|
44 to 50 |
5-10% |
|
51 to 58 |
10-20% |
|
59 to 63 |
20-30% |
|
64 to 70 |
30-50% |
|
71 to 75 |
50-70% |
|
76 to 82 |
70-90% |
|
>= 83 |
90-100% |
Performance:
• The area under the ROC cuve is 0.94.
Specialty: Nephrology
