Patient selection: Norwegians with IgA nephropathy
Parameters:
(1) proteinuria in grams per 24 hours
(2) hypertension (blood pressure >= 140/90 mm Hg or on antihypertensive therapy)
(3) histopathologic lesions
(4) eGFR in mL per min per 1.73 square meter by the CKD-EPI formula
(5) age in years at the time of diagnosis
Severe histopathologic lesions - one or more of the following:
(1) adhesions, segmental sclerosis, crescents and global sclerosis in > 10% of glomeruli
(2) interstitital inflammation or fibrosis in > 25% of the biopsy area
(3) significant vasculopathy
|
Parameter
|
Finding
|
Adjusted Odds Ratio
|
|
proteinuria
|
< 1 g per 24 hr
|
1
|
|
|
>= 1 g per 24 hr
|
2.1
|
|
hypertension
|
absent
|
1
|
|
|
present
|
1.4
|
|
histopathological lesions
|
not severe
|
1
|
|
|
severe
|
2.4
|
|
eGFR
|
>= 60
|
1
|
|
|
30 to 59.9
|
3.7
|
|
|
< 30
|
11.3
|
|
age in years
|
< 60 years
|
1
|
|
|
>= 60 years
|
1.4
|
ARR model score =
= PRODUCT (adjusted odds ratios for all 5 parameters)
Interpretation:
• minimum score: 1
• maximum score: 111.63
|
Score
|
Risk Group
|
Cumulative Risk ESRD or Death at 15 Years
|
|
1
|
A
|
3%
|
|
1.4 to 2.4
|
B
|
11%
|
|
2.9 to 7.3
|
C
|
25%
|
|
7.8 to 18.8
|
D
|
55%
|
|
22.1 to 53.2
|
E
|
77%
|
|
57 to 111.63
|
F
|
88%
|
Performance:
• The area under the ROC curve for 15-year survival is 0.88.
