Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct;24(10):3068-74.
doi: 10.1093/ndt/gfp273. Epub 2009 Jun 10.

A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study

Masashi Goto  1 , Kenji Wakai, Takashi Kawamura, Masahiko Ando, Masayuki Endoh, Yasuhiko Tomino
Affiliations

A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study

Masashi Goto et al. Nephrol Dial Transplant. 2009 Oct.

Abstract

Background: Immunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis, and a substantial number of patients succumb to end-stage renal disease (ESRD). However, prediction of the renal outcome in individual patients remains difficult. We have already published a scoring system using the data in a prospective cohort of IgAN patients followed up from 1995 to 2002.

Methods: The cohort was further followed up until 2005 in 97 clinical units in Japan. The data from 2283 patients were analysed by Cox regression to determine the predictors of ESRD in IgAN, and their beta-coefficients were converted into scores to estimate ESRD risk within 10 years.

Results: During the follow-up (median, 87 months), 252 patients developed ESRD. Male sex, age less than 30 years, family histories of chronic renal failure and chronic glomerulonephritis, hypertension, proteinuria, mild haematuria, hypoalbuminaemia, low glomerular filtration rate and a high histological grade at initial renal biopsy were associated with the risk of ESRD in the multivariable analysis. A scoring system was framed to estimate the 10-year ESRD risk using eight variables significant in both univariable and multivariable models. This prognostic score accurately classified patients by risk: patients with estimates of 0-4.9, 5.0-19.9, 20.0-49.9 and 50.0-100% had an observed incidence of 1.7, 8.3, 36.7 and 85.5%, respectively. The corresponding area under the receiver-operating characteristic curve was 0.942 (95% confidence interval, 0.925-0.958).

Conclusion: This validated scoring system to quantitatively estimate ESRD risk during the 10-year follow-up of IgAN patients will serve as a useful prognostic tool in clinical practice.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Renal survival curves by estimated 10-year risk of end-stage renal disease. Patients were categorized into four groups according to the estimated risk: low (0–4.9%, n = 1007), moderate (5.0–19.9%, n = 365), high (20.0–49.9%, n = 154) and very high (50.0–100%, n = 135). Numbers of patients at risk were 1661, 1430, 1216, 1005, 706 and 537 at 0, 2, 4, 6, 8 and 10 years, respectively.
Fig. 2
Fig. 2
The receiver-operating characteristic curve for predicting end-stage renal disease within 10 years by current scoring system.
See this image and copyright information in PMC

References

    1. Berger J, Hinglais N. Intercapillary deposits of IgA-IgG. J Urol Nephrol (Paris) 1968;74:694–695. - PubMed
    1. Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13 519 renal biopsies. Kidney Int. 2004;66:920–923. - PubMed
    1. Simon P, Ramee MP, Boulahrouz R, et al. Epidemiologic data of primary glomerular diseases in western France. Kidney Int. 2004;66:905–908. - PubMed
    1. Barratt J, Feehally J. IgA nephropathy. J Am Soc Nephrol. 2005;16:2088–2097. - PubMed
    1. D’Amico G. Natural history of idiopathic IgA nephropathy: role of clinical and histological prognostic factors. Am J Kidney Dis. 2000;36:227–237. - PubMed

Publication types