Validation of a Histologic Scoring Index for C3 Glomerulopathy
| Autor: | Macarena Centeno, Sofía Pérez Gutiérrez, Eduardo Vázquez Martul, Adriana García-Herrera, Dolores López Álvarez, Natalia Allende, M. Luisa Pérez-Ebri, Gema Fernández-Juárez, Helena Marco, Alejandra Gabaldón Domínguez, Alberto Lorenzo, Alexandra Navarro, Gloria Fraga, Francisco Caravaca, Xoana Barros, Cesáreo Corbacho Cuevas, Ana Ávila, Carmen Mon, Lucia González, Hernando Trujillo, Eva Rodríguez, Francisco Díaz Crespo, Consuelo Calvo, Marina Alonso, Angel Sevillano, Ana Saiz, Cristina Meléndez Muñoz, Ángel Panizo Santos, Vanessa Pérez Gómez, Sonia Cruz, Ana Pérez de José, Juliana Draibe, Esther Roselló Sastre, Montserrat Díaz-Encarnación, Rafael Camacho Galán, José Antonio Cortés, Luis Bravo, Belén Ferri Ñíguez, Victoria Oviedo, Fernando Caravaca-Fontán, Juan Mosquera Reboredo, Iara Da Silva, Maria Dolores Sanchez de la Nieta, Javier Lumbreras, Javier Gimeno, Carmen Guerrero Márquez, Rosa Rodríguez, Luis F. Quintana, Carles Saus, Maria Soledad Garcia-Cuerva Calvar, Rocío Cabrera-Pérez, Amir Shabaka, Virginia Cabello, Elena Goicoechea de Jorge, Enrique Morales, F. González, Ana Huerta, Teresa Cavero, Marta Garrido, Inmaculada López, Natalia Ramos, Francisco de la Cerda, Teresa Olea, Rosa Miquel, Nuria Rodríguez-Mendiola, Maria Luisa Illescas, Pablo Cannata Ortiz, Loreto Fernández, Manuel Praga, Eduardo Salido Ruiz, Eduardo Gutiérrez, Maria Eugenia García Fernández, Montserrat Gomà Gallego, Gema Ariceta, Alejando Pascual Martin, Laura Yébenes Gregorio, Marta Melgosa, Yolanda Arce |
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| Přispěvatelé: | Instituto de Salud Carlos III, European Commission, Red Española de Investigación Renal, Comunidad de Madrid, Ministerio de Ciencia, Innovación y Universidades (España), Caravaca-Fontán, Fernando, Trujillo, Hernando, Alonso, Marina, Díaz-Encarnación, Montserrat M., Cabello, Virginia, Ariceta, Gema, Quintana, Luis F., Barros, Xoana, Ramos, Natalia, Rodríguez-Mendiola, Nuria, Fernández-Juárez, Gema, de la Cerda, Francisco, Pérez de José, Ana, Pérez Gómez, Vanessa, Lumbreras, Javier, Sánchez de la Nieta, María Dolores, Olea, Teresa, Melgosa, Marta, Huerta, Ana, de Lorenzo, Alberto, Draibe, Juliana, González, Fayna, Shabaka, Amir, Goicoechea de Jorge, Elena, Praga, Manuel, Caravaca-Fontán, Fernando [0000-0002-5830-9663], Trujillo, Hernando [0000-0002-3520-1422], Alonso, Marina [0000-0003-1293-1075], Díaz-Encarnación, Montserrat M. [0000-0001-5172-3370], Cabello, Virginia [0000-0002-0877-5498], Ariceta, Gema [0000-0003-1763-1098], Quintana, Luis F. [0000-0001-7582-8476], Barros, Xoana [0000-0001-9690-9769], Ramos, Natalia [0000-0001-9832-326X], Rodríguez-Mendiola, Nuria [0000-0001-6994-7161], Fernández-Juárez, Gema [0000-0001-6641-7763], de la Cerda, Francisco [0000-0002-9983-0359], Pérez de José, Ana [0000-0002-6952-1459], Pérez Gómez, Vanessa [0000-0003-4558-5236], Lumbreras, Javier [0000-0003-1855-0724], Sánchez de la Nieta, María Dolores [0000-0001-8574-0013], Olea, Teresa [0000-0003-2370-1048], Melgosa, Marta [0000-0001-6236-414X], Huerta, Ana [0000-0003-3342-7628], de Lorenzo, Alberto [0000-0001-8847-083X], Draibe, Juliana [0000-0002-2819-8560], González, Fayna [0000-0002-2313-2511], Shabaka, Amir [0000-0001-7039-4701], Goicoechea de Jorge, Elena [0000-0002-4978-2483], Praga, Manuel [0000-0001-9270-1071] |
| Rok vydání: | 2021 |
| Předmět: |
Nephrology
Male Total activity Score Intraclass correlation Dense-deposit disease (DDD) total chronicity score 030232 urology & nephrology Kidney biopsy disease prognosis Kidney C3 glomerulonephritis (C3GN) Cohort Studies 0302 clinical medicine Glomerulonephritis Intraclass correlations Medicine 030212 general & internal medicine Renal Insufficiency Child intraclass correlations Proteinuria Confounding dense-deposit disease (DDD) Complement C3 Disease prognosis Middle Aged Prognosis kidney survival Kidney survival Kidney Tubules Disease Progression Female kidney failure total activity Score medicine.symptom Immunosuppressive Agents Glomerular Filtration Rate Adult medicine.medical_specialty Adolescent Glomerulonephritis Membranoproliferative Renal function Kidney failure histologic index prognostic tool Prognostic tool 03 medical and health sciences Young Adult Glomerulopathy C3 glomerulopathy (C3G) Internal medicine kidney biopsy Total chronicity score Humans Proportional Hazards Models Retrospective Studies business.industry Proportional hazards model Reproducibility of Results Retrospective cohort study medicine.disease Fibrosis Histologic index Atrophy business |
| Zdroj: | American Journal of Kidney Diseases r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname AMERICAN JOURNAL OF KIDNEY DISEASES r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau r-FISABIO. Repositorio Institucional de Producción Científica Digital.CSIC. Repositorio Institucional del CSIC |
| ISSN: | 0272-6386 1523-6838 |
| Popis: | 12 p.-4 fig.-4 tab. Rationale & objective: A previous study that evaluated associations of kidney biopsy findings with disease progression in patients with C3 glomerulopathy (C3G) proposed a prognostic histologic index (C3G-HI) that has not yet been validated. Our objective was to validate the performance of the C3G-HI in a new patient population. Study design: Multicenter, retrospective cohort study. Setting & participants: 111 patients fulfilling diagnostic criteria of C3G between January 1995 and December 2019, from 33 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Predictors: Demographic, clinical parameters, C3G-HI total activity score, and the C3G-HI total chronicity score. Outcome: Time to kidney failure. Analytical approach: Intraclass correlation coefficients and κ statistic were used to summarize inter-rater reproducibility for assessment of histopathology in kidney biopsies. The nonlinear relationships of risk of kidney failure with the total activity score and total chronicity score were modeled using Cox proportional hazards analysis that incorporated cubic splines. Results: The study group included 93 patients with C3 glomerulonephritis and 18 with dense-deposit disease. Participants had an overall meanage of 35±22 (SD) years. Forty-eight patients (43%) developed kidney failure after a mean follow-up of 65±27 months. The overall inter-rater reproducibility was very good for the total activity score (intraclass correlation coefficient [ICC]=0.63) and excellent for total chronicity score (ICC=0.89). Baseline estimated glomerular filtration rate (eGFR), 24-hour proteinuria, and treatment with immunosuppression were the main determinants of kidney failure in a model with only clinical variables. Only tubular atrophy and interstitial fibrosis were identified as predictors in a model with histological variables. When the total activity score and total chronicity score were added to the model, only the latter was identified as an independent predictor of kidney failure. Limitations: Only a subset of the kidney biopsies was centrally reviewed. Residual confounding. Conclusions: We validated the performance of C3G-HI as a predictor of kidney failure in patients with C3G. The total chronicity score was the principal histologic correlate of kidney failure. Work in this study was supported by the Instituto de Salud Carlos III /Fondo Europeo de Desarrollo Regional (ISCIII/FEDER) grant PI16/01685 and Red de Investigación Renal (RedInRen) (RD12/0021/0029) (to MP), the Autonomous Region of Madrid (S2017/BMD-3673) (to MP); EGdeJ is supported by the Spanish “Ministerio de Ciencia, Innovación y Universidades" (RYC-2013-13395 and RTI2018-095955-B-100). |
| Databáze: | OpenAIRE |
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