Validation of the children international IgA nephropathy prediction tool based on data in Southwest China

作者全名："Yu, Xixi; Li, Jiacheng; Tao, Chengrong; Jiao, Jia; Wan, Junli; Zhong, Cheng; Yang, Qin; Shi, Yongqi; Zhang, Gaofu; Yang, Haiping; Li, Qiu; Wang, Mo"

作者地址："[Yu, Xixi; Tao, Chengrong; Jiao, Jia; Wan, Junli; Zhong, Cheng; Yang, Qin; Shi, Yongqi; Zhang, Gaofu; Yang, Haiping; Li, Qiu; Wang, Mo] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Dept Nephrol,Minist Educ,Key Lab Child Dev & Disor, Chongqing, Peoples R China; [Li, Jiacheng] Chongqing Med Univ, Dept Hematol & Oncol, Childrens Hosp, Chongqing, Peoples R China"

通信作者："Wang, M (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, China Int Sci & Technol Cooperat Base Child Dev &, Dept Nephrol,Minist Educ,Key Lab Child Dev & Disor, Chongqing, Peoples R China."

来源：FRONTIERS IN PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001023705800001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：11

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：IgA nephropathy; prediction tool; validation; chronic kidney disease; pediatric

摘要："BackgroundImmunoglobulin A nephropathy (IgAN) is one of the most common kidney diseases leading to renal injury. Of pediatric cases, 25%-30% progress into end-stage kidney disease (ESKD) in 20-25 years. Therefore, predicting and intervening in IgAN at an early stage is crucial. The purpose of this study was to validate the availability of an international predictive tool for childhood IgAN in a cohort of children with IgAN treated at a regional medical centre. MethodsAn external validation cohort of children with IgAN from medical centers in Southwest China was formed to validate the predictive performance of the two full models with and without race differences by comparing four measures: area under the curve (AUC), the regression coefficient of linear prediction (PI), survival analysis curves for different risk groups, and R2D. ResultsA total of 210 Chinese children, including 129 males, with an overall mean age of 9.43 & PLUSMN; 2.71 years, were incorporated from this regional medical center. In total, 11.43% (24/210) of patients achieved an outcome with a GFR decrease of more than 30% or reached ESKD. The AUC of the full model with race was 0.685 (95% CI: 0.570-0.800) and the AUC of the full model without race was 0.640 (95% CI: 0.517-0.764). The PI of the full model with race and without race was 0.816 (SE = 0.006, P < 0.001) and 0.751 (SE = 0.005, P < 0.001), respectively. The results of the survival curve analysis suggested the two models could not well distinguish between the low-risk and high-risk groups (P = 0.359 and P = 0.452), respectively, no matter the race difference. The evaluation of model fit for the full model with race was 66.5% and without race was 56.2%. ConclusionsThe international IgAN prediction tool has risk factors chosen based on adult data, and the validation cohort did not fully align with the derivation cohort in terms of demographic characteristics, clinical baseline levels, and pathological presentation, so the tool may not be highly applicable to children. We need to build IgAN prediction models that are more applicable to Chinese children based on their particular data."

基金机构：National Key Ramp;D Program of China [2021YFC2702002]; Key Ramp;D Projects of Jiang Su Province (social development) [BE2021607]; National Clinical Research Center for Child Health and Disorders [NCRCCHD-2020-GP-01]

基金资助正文："This study was sponsored by the National Key R & amp;D Program of China (Grant Number: 2021YFC2702002), Key R & amp;D Projects of Jiang Su Province (social development) (Grant Number: BE2021607), and the National Clinical Research Center for Child Health and Disorders (Grant number: NCRCCHD-2020-GP-01)."