Development and validation of a prognostic nomogram for IgA nephropathy
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Jian Liu1*, Shuwei Duan1,*, Pu Chen1, Guangyan Cai1, Yong Wang1, Li Tang1, Shuwen Liu1, Jianhui Zhou1, Di Wu1, Wanjun Shen1, Xiangmei Chen1 and Jie Wu1
1Department of Nephrology, Chinese People’s Liberation Army (PLA) General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, China
*These authors have contributed equally to this work
Xiangmei Chen, email: email@example.com
Jie Wu, email: firstname.lastname@example.org
Keywords: nomogram, IgA nephropathy, prognosis, pathology, risk
Received: July 06, 2017 Accepted: August 27, 2017 Published: October 10, 2017
IgA nephropathy (IgAN) shows strong heterogeneity between individuals. IgAN prognosis is associated with pathological lesions and clinical indicators. However, simple tools for evaluating the clinical prognosis remain inadequate. Our objective was to develop an intuitive estimation tool for predicting the IgAN prognosis. 349 patients with IgAN at The Chinese People’s Liberation Army General Hospital were retrospectively analyzed from data between 2000 and 2006. A nomogram was developed using COX regression coefficients to predict decline of estimate Glomerular filtration rate (eGFR) ≥ 50% and end-stage renal disease (ESRD). The discriminative ability and predictive accuracy of the nomogram was determined via concordance index (C-index) and calibration curve. The results were verified in an independent validation cohort. In the derivation cohort, the nomogram was developed using mesangial hypercellularity, tubular atrophy/interstitial fibrosis, average proteinuria (A-P), and average mean arterial pressure (A-MAP) during hospitalization. The C-index of the nomogram was 0.88 (95% CI, 0.80 to 0.96). The calibration curve showed good agreement between prediction and actual observation. Furthermore, the nomogram demonstrated good discrimination (C-index = 0.87, 95% CI 0.78 to 0.95) and calibration in the validation cohort. The nomogram could predict the prognosis of IgAN effectively and intuitively.
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